Individual
MS. SANDRA A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5000 MENAUL BLVD NE STE B, ALBUQUERQUE, NM 87110-3046
(505) 872-1212
(505) 872-1213
Mailing address
2221 E BIJOU ST STE 100, COLORADO SPRINGS, CO 80909-8009
(719) 576-1850
(719) 955-3470
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
19025429
IL
1223G0001X
General Practice Dentistry
Primary
DD3611
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45125252
—
NM
Enumeration date
11/03/2006
Last updated
06/28/2019
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