| Dane E. Smith Dds Pc | |
|
565 5th St Brookings OR 97415-9702 | |
| (541) 469-5373 | |
| (541) 412-0177 |
| Full Name | Dane E. Smith Dds Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 565 5th St, Brookings, Oregon |
| Authorized Official Name and Position | Dane E Smith (OWNER) |
| Authorized Official Contact | 5417563683 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dane E. Smith Dds Pc 3500 Cedar St North Bend OR 97459-1108 Ph: (541) 756-3683 | Dane E. Smith Dds Pc 565 5th St Brookings OR 97415-9702 Ph: (541) 469-5373 |
| NPI Number | 1861591679 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861591679 | NPI | - | NPPES |
| 164848 | Medicaid | OR | |
| D4773 | Other | OR | DENTAL LICENSE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | D4773 (Oregon) | Primary |
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