Organization
SMIL3CHAT TELEDENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEISHA HARRIS (FOUNDER)
(229) 395-1437
Entity
Organization
Contact information
Practice address
9735 REDBIRD CREEK DR S, JACKSONVILLE, FL 32221-3294
(229) 395-1437
Mailing address
9735 REDBIRD CREEK DR S, JACKSONVILLE, FL 32221-3294
(229) 395-1437
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H62051485548
DRIVING LICENSE
FL
Enumeration date
08/31/2022
Last updated
08/31/2022
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