Organization
NORTH SHORE DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG L SMITH DDS (PRESIDENT)
(262) 242-1180
Entity
Organization
Contact information
Practice address
1345 W TOWNE SQUARE RD, MEQUON, WI 53092-5047
(262) 242-1180
(262) 236-9079
Mailing address
1345 W TOWNE SQUARE RD, MEQUON, WI 53092-5047
(262) 242-1180
(262) 236-9079
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5426-15
WI
Other
Enumeration date
01/02/2013
Last updated
01/02/2013
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