# REACHING OUT MINISTRIES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Paradise Smiles Dental Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972733053
- **Authorized official:** DR. KENNY WAYNE BOURGEOIS DDS (PRESIDENT/PRIMARY DENTAL PROVIDER)
- **Authorized official phone:** (671) 646-2010

## Contact information

- **Practice address:** 226 CHALAN SAN ANTONIO STE C, AMPARO'S BUSINESS CENTER, TAMUNING, GU 96913-3525
- **Practice address phone:** (671) 646-2010
- **Practice address fax:** (671) 646-2070
- **Mailing address:** 226 CHALAN SAN ANTONIO STE C, AMPARO'S BUSINESS CENTER, TAMUNING, GU 96913-3525
- **Mailing address phone:** (671) 646-2010
- **Mailing address fax:** (671) 646-2070

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 14605 | TX | — |
| 261QD0000X | Dental Clinic/Center | D927 | GU | Yes |

## Other

- **Enumeration date:** 07/22/2009
- **Last updated:** 07/22/2009