Individual
DANIEL JAY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14655 GALAXIE AVE, APPLE VALLEY, MN 55124-8602
(952) 225-1180
(952) 891-3921
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36718
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271723900
—
MN
Enumeration date
06/15/2006
Last updated
01/29/2020
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