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Individual

MRS. MISTY SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
HWY 270 & 56 JCT, WEWOKA, OK 74884
(405) 257-7310
(405) 257-2696
Mailing address
HWY 270 & 56 JCT, WEWOKA, OK 74884
(405) 257-7310
(405) 257-2696

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3022
OK

Other

Enumeration date
01/04/2012
Last updated
01/04/2012
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