Individual
DR. KEVIN CHARLES SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
212 ORLEANS RD STE A, NORTH CHATHAM, MA 02650-1184
(508) 945-4870
(508) 945-6062
Mailing address
212 ORLEANS RD STE A, NORTH CHATHAM, MA 02650-1184
(508) 945-4870
(508) 945-6062
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19628
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0297585
—
MA
01
—
X08517
BLUE CROSS BLUE SHIELD
MA
Enumeration date
08/01/2006
Last updated
12/31/2009
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