Individual
MARTIN MCKAY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 DESERT SAGE WAY, MOUNTAIN HOME, ID 83647-1038
(208) 587-3988
Mailing address
120 DESERT SAGE WAY, MOUNTAIN HOME, ID 83647-1038
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9971453
ID
1223G0001X
General Practice Dentistry
Primary
9971453
ID
Other
Enumeration date
04/15/2025
Last updated
05/14/2025
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