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General NPI Number Information
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NPI Number | 1164299525
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Entity Type | Organization
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Legal Business Name | NEW SMILES NEW BEGINNINGS INC
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Dates
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Enumeration Date | 12/06/2023
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Last Update Date | 12/15/2023
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Provider Practice Location Address
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Address Line | 320 1/2 ORANGE ST
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City | JACKSON
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State | MI
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Zip | 49202-3654
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Country | US
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Telephone | 517-513-4923
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Fax |
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Provider Business Mailing Address
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Address Line | 320 1/2 ORANGE ST
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City | JACKSON
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State | MI
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Zip | 49202-3654
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Country | US
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Telephone | 517-513-4923
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JAZMYN RAGLAND
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Credential | BSDH, RDH, RDA
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Telephone | 517-513-4923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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