Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DEN00201825 | CO |
NPI | 1003045493 |
---|---|
Provider Name | Dr. Alfred Patrick Smithwick III |
First Address | Aurora, CO 80016-1382 |
Second Address | Aurora, CO 80016-1382 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2009 |
Last Update Date | 13/03/2013 |