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General NPI Number Information
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NPI Number | 1265458046
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Entity Type | Individual
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Provider Name | DAVID O SMITH D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 5 S 700 E STE 204
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City | SALT LAKE CITY
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State | UT
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Zip | 84102-1699
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Country | US
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Telephone | 801-355-7021
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Fax | 801-220-0510
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Provider Business Mailing Address
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Address Line | 5 S 700 E STE 204
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City | SALT LAKE CITY
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State | UT
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Zip | 84102-1699
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Country | US
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Telephone | 801-355-7021
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Fax | 801-220-0510
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 020600578
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License Number State | UT
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