Individual
DR. SAMUEL R SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
295 ANDERSON RD, SHELLEY, ID 83274-4927
(208) 357-7900
(208) 357-7904
Mailing address
3867 AMARILLO DR, AMMON, ID 83406-5142
(801) 633-0768
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-5496
ID
Other
Enumeration date
05/03/2021
Last updated
11/18/2025
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