Individual
DR. MARK R SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1819 61ST AVE., #102, GREELEY, CO 80634
(970) 356-7474
(970) 356-2474
Mailing address
1819 61ST AVE., #102, GREELEY, CO 80634
(970) 356-7474
(970) 356-2474
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6503
CO
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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