Individual
LISA MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1320 S GREEN BAY RD, MT PLEASANT, WI 53406-4402
(262) 223-0280
Mailing address
5805 S DELAWARE AVE, CUDAHY, WI 53110-2432
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
11494-16
WI
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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