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General NPI Number Information
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NPI Number | 1962910398
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Entity Type | Individual
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Provider Name | BETSEY JO BAUMANN-SMEENGE DDS MS
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Gender | Female
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Dates
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Enumeration Date | 01/19/2018
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Last Update Date | 10/20/2021
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Provider Practice Location Address
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Address Line | 1035 E WILCOX AVE
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City | WHITE CLOUD
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State | MI
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Zip | 49349-8794
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Country | US
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Telephone | 231-689-1608
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Fax | 231-689-3162
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Provider Business Mailing Address
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Address Line | 1615 MICHIGAN AVE
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City | BALDWIN
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State | MI
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Zip | 49304-7984
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Country | US
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Telephone | 231-745-2736
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Fax | 231-745-0412
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901022472
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 2901022472
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License Number State | MI
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