Organization
SPRING PARK ORAL AND MAXILLOFACIAL SURGEONS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL R SMITH DDS (PRESIDENT/OWNER)
(563) 359-1601
Entity
Organization
Contact information
Practice address
1111 CANAL SHORE DR SW, LE CLAIRE, IA 52753-7602
(563) 355-1034
Mailing address
5345 SPRING ST, DAVENPORT, IA 52807-2764
(563) 359-1601
(563) 355-7111
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8664
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87346
—
IA
Enumeration date
02/04/2014
Last updated
04/29/2014
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