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Individual

DR. DAMIAN RALEIGH SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1345 S PUEBLO BLVD, PUEBLO, CO 81005-1508
(719) 722-3584
Mailing address
1345 S PUEBLO BLVD, PUEBLO, CO 81005-1508
(719) 542-3595

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DD4376
NM
1223G0001X
General Practice Dentistry
Primary
DEN.00204697
CO

Other

Enumeration date
08/09/2015
Last updated
09/14/2021
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