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NPI Code Detail

MEDICARE: SMITH & ENGEL DENTISTRY

MEDICARE: SMITH & ENGEL DENTISTRY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry6408AZ

General Provider Information

NPI Number : 1205913241
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMITH & ENGEL DENTISTRY
Provider Business Mailing Address
First Line : 2919 S ELLSWORTH RD
Second Line : SUITE 118
City : MESA
State : AZ
Zip : 85212-2164
Country : US
Telephone Number : 480-219-1384
Fax Number : 480-219-1394
Provider Business Practice Location Address
First Line : 2919 S ELLSWORTH RD
Second Line : SUITE 118
City : MESA
State : AZ
Zip : 85212-2164
Country : US
Telephone Number : 480-219-1384
Fax Number : 480-219-1394
Authorized Official
Title or Position : OWNER
Name : DR. NATHAN WADSWORTH SMITH
Credential : DMD
Telephone Number : 480-219-1384
Provider Enumeration Date : 11/01/2006
Last Update Date : 08/22/2020

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Directions to “SMITH & ENGEL DENTISTRY ” Practice Location

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