Provider Demographics
NPI:1104963149
Name:SMITH, CHRISTINA (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12301 TAFT ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4387
Mailing Address - Country:US
Mailing Address - Phone:953-962-8311
Mailing Address - Fax:954-435-1739
Practice Address - Street 1:12301 TAFT ST
Practice Address - Street 2:SUITE 300
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-4387
Practice Address - Country:US
Practice Address - Phone:953-962-8311
Practice Address - Fax:954-435-1739
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL178361223P0221X
NY0530871223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry