Samuel M Smith Dmd Phd Pc | |
1519 East Mccord St Centralia IL 62801 | |
(618) 532-1879 | |
(618) 532-0479 |
Full Name | Samuel M Smith Dmd Phd Pc |
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Speciality | Dentist |
Location | 1519 East Mccord St, Centralia, Illinois |
Authorized Official Name and Position | Samuel Madison Smith (OWNER) |
Authorized Official Contact | 6185321879 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Samuel M Smith Dmd Phd Pc 1519 East Mccord St Centralia IL 62801 Ph: (618) 532-1879 | Samuel M Smith Dmd Phd Pc 1519 East Mccord St Centralia IL 62801 Ph: (618) 532-1879 |
NPI Number | 1174791990 |
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Provider Enumeration Date | 02/14/2008 |
Last Update Date | 02/14/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174791990 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
Shah Dental Clinic,llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 135 S Sycamore St, Centralia, IL 62801 Phone: 618-532-1411 Fax: 618-532-1496 | |
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