Organization
NEWSMILE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN JAQUES DMD (OWNER)
(803) 496-9012
Entity
Organization
Contact information
Practice address
303 BUNCH FORD RD, HOLLY HILL, SC 29059-8401
(803) 496-9012
Mailing address
303 BUNCH FORD RD, HOLLY HILL, SC 29059-8401
(803) 496-9012
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZ2538
—
SC
Enumeration date
08/14/2018
Last updated
08/14/2018
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