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Individual

LOGAN SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7613 ESTHER CIR, FREDERICK, CO 80504-5881
(303) 848-3633
Mailing address
6173 S JACKSON GAP CT, AURORA, CO 80016-2797
(303) 748-6981

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DEN.00206171
CO

Other

Enumeration date
01/09/2025
Last updated
01/09/2025
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