Provider Demographics
NPI:1679769087
Name:SMITH, CHRISTOPHER A (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:A
Last Name:SMITH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23320 HIGHWAY 99
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8744
Mailing Address - Country:US
Mailing Address - Phone:425-640-5500
Mailing Address - Fax:425-640-5534
Practice Address - Street 1:23320 HIGHWAY 99
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8744
Practice Address - Country:US
Practice Address - Phone:425-640-5500
Practice Address - Fax:425-640-5534
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000110981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice