Individual
DR. RYAN DOUGLAS SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
24 E 3RD S, SAINT ANTHONY, ID 83445-1809
(208) 624-4322
(208) 624-4634
Mailing address
24 E 3RD S, SAINT ANTHONY, ID 83445-1809
(208) 624-4322
(208) 624-4634
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4364
ID
Other
Enumeration date
07/18/2011
Last updated
07/18/2011
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