Individual
DR. GARY MICHAEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MSD SC
Contact information
Practice address
2600 N MAYFAIR RD, SUITE 825, WAWWATOSA, WI 53226
(414) 257-3170
(414) 257-2054
Mailing address
2600 N MAYFAIR RD, SUITE 825, WAWWATOSA, WI 53226
(414) 257-3170
(414) 257-2054
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
492G
WI
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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