Individual
MRS. JODI BASIAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2843 VISTAVIEW DR NW, GRAND RAPIDS, MI 49544-8204
(616) 328-7409
Mailing address
2843 VISTAVIEW DR NW, GRAND RAPIDS, MI 49544-8204
(616) 328-7409
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902012957
MI
Other
Enumeration date
12/01/2015
Last updated
12/01/2015
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