Individual
DR. JESSE WAYLON SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1801 W WISCONSIN AVE, #206, MILWAUKEE, WI 53233-2186
(414) 288-6508
Mailing address
1100 W WELLS ST, #1107, MILWAUKEE, WI 53233-2332
(414) 397-0093
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
5684-015
WI
Other
Enumeration date
02/23/2006
Last updated
07/08/2007
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