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Provider Information for 1104858778

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. CONSTANCE ELIZABETH SMITH D.D.S.

Gender: FEMALE

Individual NPI: 1104858778

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1104858778
Enumeration Date 2006-07-06
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1931 HORTON RD SUITE #14
JACKSON, MI 49203-5594
United States

Phone: 517-787-7520 | Fax: 517-787-2575
View Map External Link
Primary Practice Address 1931 HORTON RD SUITE #14
JACKSON, MI 49203-5594
United States

Phone: 517-787-7520 | Fax: 517-787-2575
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist MI 2901012155