Individual provider · Type 1 NPI
Gary Michael Smith, DDS MSD SC
Periodontics · Wawwatosa, WI
NPI number
1912045709
Active
Practice location
2600 N Mayfair Rd, Suite 825
Wawwatosa, WI 53226
Fax (414) 257-2054
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Periodontics Primary | 1223P0300X | 492G (WI) |
Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
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About NPI 1912045709
Gary Michael Smith, DDS MSD SC's National Provider Identifier is 1912045709, issued on Feb 2, 2007. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Wawwatosa, WI. The record was last updated on Jul 8, 2007.