Organization
BOULDER CANYON DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN BARCLAY SMITH DDS (DENTIST/OWNER)
(303) 442-4437
Entity
Organization
Contact information
Practice address
3093 BROADWAY ST, BOULDER, CO 80304-3151
(303) 442-4437
Mailing address
3093 BROADWAY ST, BOULDER, CO 80304-3151
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
00202990
CO
Other
Enumeration date
12/22/2016
Last updated
12/22/2016
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