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General NPI Number Information
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NPI Number | 1649990888
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Entity Type | Organization
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Legal Business Name | NURTURING SMILES
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 2006 TASKER ST
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City | PHILADELPHIA
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State | PA
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Zip | 19145-1432
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Country | US
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Telephone | 215-874-3423
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 CHESTNUT ST SUITE 2 #1304
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City | PHILADELPHIA
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State | PA
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Zip | 19102
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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 | PRESIDENT
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Name | JESSICA JEAN-BURTON
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Credential | RDH, PDHP, MPA
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Telephone | 610-710-6493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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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 | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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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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