Organization
D RALEIGH SMITH DMD, PLLC
Active
Other names
Pueblo Dental
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL MEARES (OPERATIONS MANAGER)
(719) 542-3595
Entity
Organization
Contact information
Practice address
1345 S PUEBLO BLVD, PUEBLO, CO 81005-1508
(719) 542-3595
Mailing address
1345 S PUEBLO BLVD, PUEBLO, CO 81005-1508
(719) 542-3595
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740666007
INDIVIDUAL NPI (TYPE 1)
—
Enumeration date
08/26/2021
Last updated
08/26/2021
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