Provider Demographics
NPI:1992711881
Name:SMITH, DENNIS EDWARD II (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:EDWARD
Last Name:SMITH
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5620 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-9016
Mailing Address - Country:US
Mailing Address - Phone:918-664-8156
Mailing Address - Fax:918-664-6344
Practice Address - Street 1:5620 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-9016
Practice Address - Country:US
Practice Address - Phone:918-664-8156
Practice Address - Fax:918-664-6344
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK51281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice