Individual
MR. TIMOTHY BLAIR SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
310 SE 2ND, SUITE 203, PENDLETON, OR 97801
(541) 276-4768
(541) 276-9365
Mailing address
PO BOX 1246, PENDLETON, OR 97801
(541) 276-4768
(541) 276-9365
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6928
OR
Other
Enumeration date
02/09/2007
Last updated
07/08/2007
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