Provider Demographics
NPI:1578306080
Name:SMITH, CAITLIN GRACE (DDS)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:GRACE
Last Name:SMITH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4580 ACKERLY FARM RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-9608
Mailing Address - Country:US
Mailing Address - Phone:614-560-7455
Mailing Address - Fax:
Practice Address - Street 1:370 W COSHOCTON ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:OH
Practice Address - Zip Code:43031-1113
Practice Address - Country:US
Practice Address - Phone:740-967-6046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0274801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice