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NPI Code Detail

MEDICARE: WILSON-SMITH DENTAL INC

MEDICARE: WILSON-SMITH DENTAL INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistM890SD

General Provider Information

NPI Number : 1073733432
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILSON-SMITH DENTAL INC
Provider Business Mailing Address
First Line : 720 N SYCAMORE AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57110-5740
Country : US
Telephone Number : 605-338-6118
Fax Number : 605-335-4798
Provider Business Practice Location Address
First Line : 720 N SYCAMORE AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57110-5740
Country : US
Telephone Number : 605-338-6118
Fax Number : 605-335-4798
Authorized Official
Title or Position : OWNER
Name : DR. MICHAEL CRAIG SMITH
Credential : DDS
Telephone Number : 605-338-6118
Provider Enumeration Date : 04/26/2007
Last Update Date : 08/22/2020

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Directions to “WILSON-SMITH DENTAL INC ” Practice Location

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