Individual
DANIEL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3520 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4175
(414) 645-0365
Mailing address
3520 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4175
(414) 645-0365
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6769-15
WI
Other
Enumeration date
07/27/2011
Last updated
07/27/2011
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