Jared Smith, Professional LLC

NPI #1992279384 in Bailey, Colorado

Provider Information

NPI Number: 1992279384
Entity Type: Organization
Organization Name: Jared Smith, Professional LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 18, 2019
Last Updated: Jan 18, 2019

Practice Location

Address: 17 COUNTY ROAD 68
City: Bailey
State: Colorado
ZIP Code: 80421
Phone: (303) 838-2224

Authorized Official

Name: DR. JARED SPENCER SMITH, DMD
Title: OWNER DENTIST
Phone: (801) 979-9342

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Prosthodontics — Prosthodontics	1223P0700X
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X
Dentist - Endodontics — Endodontics	1223E0200X
Dentist - General Practice — General Practice	1223G0001X	Primary

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