Individual
CHRISTOPHER BLAKE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.D.
Contact information
Practice address
1500 19TH ST S, BIRMINGHAM, AL 35205-5628
(205) 933-2773
Mailing address
1500 19TH ST S, BIRMINGHAM, AL 35205-5628
(205) 933-2772
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5611
AL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5611
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/19/2008
Last updated
08/29/2019
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