Individual
MICKEY DEAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
844 6TH ST, CLARKSTON, WA 99403-2013
(208) 848-8308
Mailing address
844 6TH ST, CLARKSTON, WA 99403-2013
(208) 848-8308
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
60778846
WA
Other
Enumeration date
08/16/2017
Last updated
07/21/2022
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