Individual
CICELY BROOKE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1300 S ELISEO DR, SUITE 100, GREENBRAE, CA 94904-2023
(415) 461-0414
Mailing address
8520 SHERWOOD DR, APT. 3, WEST HOLLYWOOD, CA 90069-4719
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
62399
CA
Other
Enumeration date
06/26/2013
Last updated
06/26/2013
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