Individual
ANDREW SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
19657 WA-410, BONNEY LAKE, WA 98391
(253) 780-7003
Mailing address
16306 107TH CT SE, YELM, WA 98597-7652
(360) 481-1172
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE61175335
WA
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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