Provider Demographics
NPI:1104130244
Name:SMITH, ADRIANNE CHRISTINE (DMD)
Entity type:Individual
Prefix:
First Name:ADRIANNE
Middle Name:CHRISTINE
Last Name:SMITH
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 1:397 KENOLIO RD
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-9024
Mailing Address - Country:US
Mailing Address - Phone:808-635-0802
Mailing Address - Fax:
Practice Address - Street 1:10 HOOHUI RD
Practice Address - Street 2:SUITE 208
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-9256
Practice Address - Country:US
Practice Address - Phone:808-665-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-24151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice