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Individual

DR. CHARLES V SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
217 E. 4TH ST, BLAIR, WI 54616-0816
(608) 989-2771
(608) 989-9626
Mailing address
PO BOX 816, 217 E. 4TH ST, BLAIR, WI 54616-0816
(608) 989-2771
(608) 989-9626

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5001157
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33592400
WI
Enumeration date
07/25/2006
Last updated
05/29/2013
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