Provider Demographics
NPI:1417449893
Name:SMIGIEL, ADAM CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:CHRISTOPHER
Last Name:SMIGIEL
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 1:13551 STEELECROFT PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-7564
Mailing Address - Country:US
Mailing Address - Phone:704-247-6770
Mailing Address - Fax:704-313-5677
Practice Address - Street 1:13551 STEELECROFT PKWY STE 130
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-7564
Practice Address - Country:US
Practice Address - Phone:704-247-6770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11013122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
85-3959254OtherEINS