Individual
DR. GREGG W. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2186 N HOSPITAL BLVD STE 1, SULLIVAN, IN 47882-7654
(812) 268-4010
(812) 268-5607
Mailing address
2186 N HOSPITAL BLVD STE 1, PO BOX 468, SULLIVAN, IN 47882-7654
(812) 268-4010
(812) 268-5607
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12007736A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100225990
—
IN
Enumeration date
01/06/2006
Last updated
02/22/2016
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