Individual
DR. JOHN PATRICK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1114 ANN ST STE 1-PO # 487, DELAVAN, WI 53115-1938
(262) 728-8232
(262) 728-8259
Mailing address
1114 ANN ST STE 1-PO # 487, DELAVAN, WI 53115-1938
(262) 728-8232
(262) 728-8259
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3790
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33495800
—
WI
Enumeration date
10/11/2006
Last updated
10/02/2007
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