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Individual

DR. MICHAEL T SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
16 N JACKSON ST, BELLEVILLE, IL 62220-1425
(618) 235-5141
(618) 235-2155
Mailing address
16 N JACKSON ST, BELLEVILLE, IL 62220-1425
(618) 235-5141
(618) 235-2155

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019028833
IL

Other

Enumeration date
09/01/2011
Last updated
02/28/2021
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