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Contact Information

MARK D SMITH, DDS
1205 E ROSS BYPASS
TAHLEQUAH, OK74464
 Phone: 918-456-2555
 Fax: 918-456-2444
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for MARK D SMITH · (Male)

NPI # 1124096755
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 03/09/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • OK License # 5389
  • OK Medicaid 20020390
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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