Provider Demographics
NPI:1366545659
Name:SMITH, ROXANNE DONAGHEY (DDS)
Entity type:Individual
Prefix:DR
First Name:ROXANNE
Middle Name:DONAGHEY
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:PO BOX 400
Mailing Address - Street 2:7811 FM 902 W.
Mailing Address - City:HOWE
Mailing Address - State:TX
Mailing Address - Zip Code:75459-0400
Mailing Address - Country:US
Mailing Address - Phone:903-532-3990
Mailing Address - Fax:903-532-6161
Practice Address - Street 1:7811 FM 902 W.
Practice Address - Street 2:
Practice Address - City:HOWE
Practice Address - State:TX
Practice Address - Zip Code:75459-0400
Practice Address - Country:US
Practice Address - Phone:903-532-3990
Practice Address - Fax:903-532-6161
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX129081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice