Individual
MS. DENA LOU SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D. FACS
Contact information
Practice address
615 BLACK RIDGE LANE, NIPOMO, CA 93444
(805) 929-5220
(805) 929-5220
Mailing address
615 BLACK RIDGE LANE, NIPOMO, CA 93444
(805) 929-5220
(805) 929-5220
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A-20644
CA
Other
Enumeration date
06/09/2015
Last updated
06/09/2015
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