Individual
DR. JUSTIN RICHARD SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3710 168TH ST NE, SUITE B-105, ARLINGTON, WA 98223-8461
(360) 657-1650
(360) 657-1502
Mailing address
360 ALDER ST, CAMANO ISLAND, WA 98282-8672
(360) 657-1650
(360) 657-1502
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
19026756
IL
1223P0221X
Pediatric Dentistry
Primary
DE 10914
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5054846
—
WA
Enumeration date
05/17/2007
Last updated
05/20/2008
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