Individual
STEPHANIE ANN MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, CDHC, BSDH
Contact information
Practice address
4241 IL-14, CHRISTOPHER, IL 62822
(618) 724-2401
Mailing address
410 E BOND ST, BENTON, IL 62812-2056
(618) 663-7178
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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