Individual
DR. SAMUEL G. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.,M.S.
Contact information
Practice address
1541 S. TIMES SQUARE, BOISE, ID 83709
(208) 321-7006
(208) 375-4647
Mailing address
1541 S. TIMES SQUARE, BOISE, ID 83709
(208) 321-7006
(208) 375-4647
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D-3549-OR
ID
Other
Enumeration date
08/15/2006
Last updated
07/08/2007
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