Individual
DR. KENNETH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1100 N GATEWAY DR, MADERA, CA 93637-9600
(213) 444-0295
Mailing address
1100 N GATEWAY DR, MADERA, CA 93637-9600
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
100917
CA
Other
Enumeration date
04/17/2017
Last updated
04/18/2017
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