DR. Mark Smith Cannon, D.M.D.

NPI #1083813810 in Boulder, Colorado

Provider Information

NPI Number: 1083813810
Entity Type: Individual
Name: DR. Mark Smith Cannon, D.M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.M.D.
Enumeration Date: Jul 12, 2007
Last Updated: Jul 12, 2007

Practice Location

Address: 3400 ARAPAHOE AVE
City: Boulder
State: Colorado
ZIP Code: 80303-1023
Phone: (303) 444-2129

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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