Provider Demographics
NPI:1497216691
Name:SMITH & HENDRICK DDS PLLC
Entity Type:Organization
Organization Name:SMITH & HENDRICK DDS PLLC
Other - Org Name:32 INSPIRED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:HENDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:980-729-5200
Mailing Address - Street 1:8604 CLIFF CAMERON DR STE 170
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-8508
Mailing Address - Country:US
Mailing Address - Phone:980-729-5200
Mailing Address - Fax:
Practice Address - Street 1:2901 COLTSGATE RD STE 201
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-3530
Practice Address - Country:US
Practice Address - Phone:704-362-1211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty