Individual
CHARLES DAVID SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1959 NE PACIFIC STREET; HSB ROOM B 241, SEATTLE, WA 98195-0001
(218) 849-6683
Mailing address
PO BOX 357134, SEATTLE, WA 98195-7134
(218) 849-6683
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DR61069016
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2020
Last updated
07/22/2020
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