Individual
RANDY L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4614 E SHEA BLVD STE D230, PHOENIX, AZ 85028-6027
(602) 996-3993
(602) 996-0675
Mailing address
4614 E SHEA BLVD STE D230, PHOENIX, AZ 85028-6027
(602) 996-3993
(602) 996-0675
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2602
AZ
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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