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NPI Code Detail

MEDICARE: DR. MICHAEL CRAIG SMITH DDS

MEDICARE: DR. MICHAEL CRAIG SMITH DDS
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
11223G0001XGeneral Practice DentistryM890SD

General Provider Information

NPI Number : 1235233255
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL CRAIG SMITH DDS
Provider Business Mailing Address
First Line : 1305 N VAIL DR
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57110-5722
Country : US
Telephone Number : 605-332-9057
Fax Number :
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 :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2006
Last Update Date : 07/08/2007

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