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Individual

DR. CRAIG LAMONT SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
1345 W TOWNE SQUARE RD, MEQUON, WI 53092-5047
(262) 242-1180
(262) 236-9079
Mailing address
1345 W TOWNE SQUARE RD, MEQUON, WI 53092-5047
(262) 242-1180
(262) 236-9079

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5426-015
WI
1223G0001X
General Practice Dentistry
6010
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
860967
AZ
Enumeration date
07/28/2005
Last updated
01/02/2013
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