Provider Demographics
NPI:1851655427
Name:SMUTZ, JUSTIN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:M
Last Name:SMUTZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11890 W 64TH AVE
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-4324
Mailing Address - Country:US
Mailing Address - Phone:303-422-0094
Mailing Address - Fax:
Practice Address - Street 1:11890 W 64TH AVE
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-4324
Practice Address - Country:US
Practice Address - Phone:303-422-0094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN-107661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice