Individual
MR. DALLAS R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
4212 N 16TH ST, BEHAVIORAL HEALTH, BUILDING 5, PHOENIX, AZ 85016-5319
(602) 263-1200
Mailing address
4212 N 16TH ST, BEHAVIORAL HEALTH, BUILDING 5, PHOENIX, AZ 85016-5319
(602) 263-1200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3666
AZ
Other
Enumeration date
08/24/2007
Last updated
04/02/2012
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