Individual
NATHAN WADSWORTH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2058 S DOBSON RD STE 12, MESA, AZ 85202-6455
(480) 838-3033
Mailing address
1669 E INDIGO ST, GILBERT, AZ 85298-3218
(480) 254-2763
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6408
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902610
UNITED CONCORDIA
AZ
Enumeration date
11/30/2006
Last updated
06/23/2021
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