Individual
DR. GRANT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
962 OLD M 66 NW, KALKASKA, MI 49646-8643
(231) 258-9061
Mailing address
6455 E LINGAUR RD, LAKE LEELANAU, MI 49653-9541
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901601457
MI
1223G0001X
General Practice Dentistry
Primary
2901601457
MI
Other
Enumeration date
07/08/2022
Last updated
04/09/2024
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