Individual
MR. REED KIM SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
115 E CHAPEL ROAD, POCATELLO, ID 83201
(208) 237-6848
(208) 237-6811
Mailing address
115 E CHAPEL ROAD, POCATELLO, ID 83201
(208) 237-6848
(208) 237-6811
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1967
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6K208
BLUE CROSS
—
Enumeration date
10/24/2006
Last updated
07/08/2007
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