Individual
BRENDAN SCOTT SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
124 N 12TH ST, QUINCY, IL 62301-3021
(217) 222-5058
Mailing address
3814 DULANEY PL, QUINCY, IL 62305-0815
(217) 779-8871
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019033809
IL
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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