Individual
DR. RICHARD TYLER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2581 DEVELOPMENT DR, GREEN BAY, WI 54311-4247
(920) 347-0400
Mailing address
1035 KEPLER DR, GREEN BAY, WI 54311-8320
(920) 301-1327
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
4041
AR
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6001447
WI
Other
Enumeration date
06/04/2015
Last updated
09/18/2024
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