Provider Demographics
NPI:1326041872
Name:SMITH, ADAM K (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:K
Last Name:SMITH
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 1:402 E 65TH ST
Mailing Address - Street 2:APT 1E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-7117
Mailing Address - Country:US
Mailing Address - Phone:212-734-3427
Mailing Address - Fax:
Practice Address - Street 1:402 E 65TH ST
Practice Address - Street 2:APT 1E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-7117
Practice Address - Country:US
Practice Address - Phone:212-734-3427
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-28
Last Update Date:2007-07-08
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
NY0336981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice