Individual
DR. TIMOTHY JOSE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
717 ENCINO PL NE STE 6, ALBUQUERQUE, NM 87102-2624
(505) 247-8005
(505) 843-5893
Mailing address
500 BARNETT RD, BOSQUE FARMS, NM 87068-8145
(505) 869-2307
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD2781
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
56075367
—
NM
Enumeration date
10/02/2006
Last updated
12/07/2011
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