Provider Demographics
NPI:1568514479
Name:SMITH, BRENT J (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:J
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5161 E ARAPAHOE RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2387
Mailing Address - Country:US
Mailing Address - Phone:303-741-2211
Mailing Address - Fax:303-741-2453
Practice Address - Street 1:5161 E ARAPAHOE RD
Practice Address - Street 2:SUITE 350
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-2387
Practice Address - Country:US
Practice Address - Phone:303-741-2211
Practice Address - Fax:303-741-2453
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2008-03-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO287652082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC87191OtherPTAN