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Individual

DR. PAUL R SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
5345 SPRING STREET, DAVENPORT, IA 52807-0000
(563) 359-1601
(563) 355-7111
Mailing address
5345 SPRING ST, DAVENPORT, IA 52807-2764
(563) 359-1601
(563) 355-7111

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7850
IA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
8846
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0142778
IA
05
142778
IA
05
2142778
IA
Enumeration date
03/21/2006
Last updated
07/08/2010
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