| Cv Smith Sc | |
|
217 E 4th Street Blair WI 54616 | |
| (608) 989-2771 | |
| (608) 989-9626 |
| Full Name | Cv Smith Sc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 217 E 4th Street, Blair, Wisconsin |
| Authorized Official Name and Position | Charles V Smith (DENTIST) |
| Authorized Official Contact | 6089892771 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cv Smith Sc Po Box 816 Blair WI 54616-0816 Ph: (608) 989-2771 | Cv Smith Sc 217 E 4th Street Blair WI 54616 Ph: (608) 989-2771 |
| NPI Number | 1730215393 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 05/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730215393 | NPI | - | NPPES |
| 831108 | Other | UNITED CONCORDIA | |
| 33592400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5001157-015 (Wisconsin) | Primary |