Individual
DR. JEDIDIAH DAVID SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1818 S 300 W, SALT LAKE CITY, UT 84115-1805
(801) 485-9715
Mailing address
1945 E BRANDON PARK WAY, SANDY, UT 84092-5234
(801) 842-1728
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046010703
IL
152W00000X
Optometrist
Primary
9488924-9934
UT
Other
Enumeration date
08/14/2013
Last updated
06/29/2016
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