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General NPI Number Information
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NPI Number | 1467337907
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Entity Type | Individual
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Provider Name | RONDA SUE SMITH RDH
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Gender | Female
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 1810 RUDDIMAN DR STE A
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City | N MUSKEGON
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State | MI
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Zip | 49445-3172
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Country | US
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Telephone | 231-744-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 2763 FOUR POINT LN
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City | TWIN LAKE
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State | MI
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Zip | 49457-8619
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2902011234
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License Number State | MI
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