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NPI Code Detail

MEDICARE: DR. ERIC MICHAEL SMITH D.D.S.

MEDICARE:  DR. ERIC MICHAEL SMITH  D.D.S.
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 DentistryDD2986NM
21223G0001XGeneral Practice DentistryDEN00202518CO

General Provider Information

NPI Number : 1396902177
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIC MICHAEL SMITH D.D.S.
Provider Business Mailing Address
First Line : PO BOX 2336
Second Line :
City : PAGOSA SPRINGS
State : CO
Zip : 81147-2312
Country : US
Telephone Number : 970-264-9436
Fax Number :
Provider Business Practice Location Address
First Line : 308 PAGOSA ST #2336
Second Line :
City : PAGOSA SPRINGS
State : CO
Zip : 81147
Country : US
Telephone Number : 970-264-9436
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2008
Last Update Date : 12/29/2023

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Directions to “ DR. ERIC MICHAEL SMITH D.D.S.” Practice Location

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