Individual
DR. SUSAN CONNIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, PC
Contact information
Practice address
5805 SE MILWAUKIE AVE, PORTLAND, OR 97202-5255
(503) 233-5825
(503) 239-7268
Mailing address
5805 SE MILWAUKIE AVE, PORTLAND, OR 97202-5255
(503) 233-5825
(503) 239-7268
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6200
OR
Other
Enumeration date
08/15/2006
Last updated
07/08/2007
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