Provider Demographics
NPI:1477572576
Name:SMITH, ALEXANDER WALTER (PHD, DMD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:WALTER
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHD, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 W 80TH AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80030-4413
Mailing Address - Country:US
Mailing Address - Phone:303-427-8690
Mailing Address - Fax:303-427-6992
Practice Address - Street 1:4850 W 80TH AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80030-4413
Practice Address - Country:US
Practice Address - Phone:303-427-8690
Practice Address - Fax:303-427-6992
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO89811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice