Individual
DR. TUCKER COLIN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5898 WOODLAND DR, WAUNAKEE, WI 53597-8714
(608) 849-4794
Mailing address
624 FOX HOLW, DEKALB, IL 60115-2391
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1001607-15
WI
Other
Enumeration date
06/26/2017
Last updated
06/26/2017
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