Individual
DR. GARY RALPH SMISEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
501 TANGLEWOOD DR, SHOREVIEW, MN 55126-2016
(651) 483-6747
(707) 760-4579
Mailing address
1986 SHARONDALE AVE, ROSEVILLE, MN 55113-5437
(651) 636-4063
(170) 776-0457
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7909
MN
Other
Enumeration date
01/28/2006
Last updated
07/08/2007
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