Individual
MRS. HALLIE KAY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1530 NORWAY ST NE, SALEM, OR 97301-0433
(541) 619-9743
Mailing address
1530 NORWAY ST. NE, SALEM, OR 97301
(541) 619-9743
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5104
OR
Other
Enumeration date
05/11/2010
Last updated
05/11/2010
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