Provider Demographics
NPI:1003035668
Name:SMART, CHAD W (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:W
Last Name:SMART
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2302 S UNION AVE
Mailing Address - Street 2:STE B-14
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1300
Mailing Address - Country:US
Mailing Address - Phone:253-752-3949
Mailing Address - Fax:253-752-6392
Practice Address - Street 1:2302 S UNION AVE
Practice Address - Street 2:STE B-14
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1300
Practice Address - Country:US
Practice Address - Phone:253-752-3949
Practice Address - Fax:253-752-6392
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WADE000090921223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics