Individual
MS. DOMINIQUE MARIELLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA-HIS
Contact information
Practice address
30550 STEPHENSON HWY, MADISON HEIGHTS, MI 48071-1611
(248) 837-6298
(248) 837-6299
Mailing address
18800 EUREKA RD, SOUTHGATE, MI 48195-3166
(734) 285-3770
(734) 285-3781
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
3501004948
MI
237700000X
Hearing Instrument Specialist
3501004958
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15013663
—
MI
Enumeration date
06/07/2014
Last updated
12/13/2022
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