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Individual

DR. MANDIE LYNN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
829 CHIEF EDDIE HOFFMAN HIGHWAY, BETHEL, AK 99559
(907) 543-6229
Mailing address
PO BOX 709, BETHEL, AK 99559-0709
(907) 543-7795

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
21424
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DD4131
AK
Enumeration date
04/11/2007
Last updated
07/08/2007
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