Provider Demographics
NPI:1922795285
Name:WASIK-SMIETANA, AGNIESZKA (DMD)
Entity Type:Individual
Prefix:DR
First Name:AGNIESZKA
Middle Name:
Last Name:WASIK-SMIETANA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12018 CEDAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1641
Mailing Address - Country:US
Mailing Address - Phone:832-805-9705
Mailing Address - Fax:
Practice Address - Street 1:2310 SETTLERS WAY BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5260
Practice Address - Country:US
Practice Address - Phone:281-265-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39162122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist