Individual
DR. SHANE MICHAEL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2919 BROWNS LN, JONESBORO, AR 72401-7203
(870) 932-2644
Mailing address
2919 BROWNS LN, JONESBORO, AR 72401-7203
(870) 932-2644
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2016021062
MO
1223G0001X
General Practice Dentistry
Primary
4127
AR
Other
Enumeration date
07/25/2016
Last updated
09/06/2023
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