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General NPI Number Information
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NPI Number | 1235222498
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Entity Type | Individual
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Provider Name | CYNTHIA ANN SMITH R.D.H.
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5TH & ROSSEVELT RD. BLDG. 200 C129
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City | HINES
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State | IL
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Zip | 60141
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Country | US
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Telephone | 708-202-8387
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Fax | 708-202-2332
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Provider Business Mailing Address
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Address Line | 114 EL DORADO CT
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City | MINOOKA
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State | IL
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Zip | 60447-9348
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Country | US
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Telephone | 815-467-2012
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State | IL
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