Organization
WASHINGTON SQUARE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA ANN SMITH D.D.S, P.C. (OWNER)
(636) 239-7828
Entity
Organization
Contact information
Practice address
1015 WASHINGTON SQ STE E, WASHINGTON, MO 63090-5307
(636) 239-7828
(636) 239-5048
Mailing address
1015 WASHINGTON SQ STE E, WASHINGTON, MO 63090-5307
(636) 239-7828
(636) 239-5048
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2004013254
MO
Other
Enumeration date
08/13/2007
Last updated
08/13/2007
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