Individual
DR. JOHN MICHAEL SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
15380 BAGLEY RD, MIDDLEBURG HEIGHTS, OH 44130-4824
(440) 888-6300
(440) 888-6329
Mailing address
468 COUNTRYSIDE DR, BROADVIEW HEIGHTS, OH 44147-3413
(440) 582-0612
(440) 582-0622
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
17587
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0596029
—
OH
01
—
483091
UNITED CONCORDIA INSURANC
—
Enumeration date
05/27/2005
Last updated
07/08/2007
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