Organization
NIZHONI SMILES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIA FREELAND (CHIEF OPERATING OFFICER)
(505) 368-5626
Entity
Organization
Contact information
Practice address
N HWY 491, SHIPROCK, NM 87420-3449
(505) 368-5626
Mailing address
PO BOX 3449, NORTH HWY 491, SHIPROCK, NM 87420-3449
(505) 368-5626
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
812033
—
AZ
05
—
H8402
—
NM
Enumeration date
12/27/2006
Last updated
08/22/2020
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