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General NPI Number Information
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NPI Number | 1295373207
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Entity Type | Organization
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Legal Business Name | COLBY SMITH DDS, INC
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Dates
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Enumeration Date | 12/20/2019
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 7060 DOUGLAS BLVD
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City | GRANITE BAY
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State | CA
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Zip | 95746-6250
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Country | US
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Telephone | 916-735-4720
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Fax |
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Provider Business Mailing Address
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Address Line | 8769 AUBURN FOLSOM RD
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City | GRANITE BAY
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State | CA
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Zip | 95746-6203
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Country | US
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Telephone | 916-735-4720
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. COLBY S SMITH
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Credential | DDS
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Telephone | 310-948-9198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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