Individual
TAMARA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S.D
Contact information
Practice address
4187 161ST LN NW, ANDOVER, MN 55304-2274
(651) 303-8041
(651) 303-8041
Mailing address
4187 161ST LN NW, ANDOVER, MN 55304-2274
(651) 303-8041
(651) 303-8041
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D12904
MN
Other
Enumeration date
07/28/2011
Last updated
09/02/2015
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