Doctor Name: | CHRISTOPHER R SMITH |
NPI Number: | 1134284979 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DDS |
License Number: | |
Business Practice Address: | 180 Harvester Dr Ste 110 Burr Ridge, IL - 605276686 |
Business Phone Number: | 7738344064 |
Business Fax Number: | |
Mailing Address: | 5841 S Maryland Ave # Mc1099, CHICAGO |
State: | IL |
Postal Code: | 606371447 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/22/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204E00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Oral & Maxillofacial Surgery |
Taxonomy Specialization: | |
Taxonomy Definition: |