Jacksonville Smiles
Organization Active NPI Dentist · Jacksonville, TX
NPI 1457736100 · NPPES record last updated Jul 23, 2015
Key facts
- NPI
- 1457736100
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 30949 (TX)
- Legal business name
- JACKSONVILLE SMILES
- Practice address
- 606 Brookside Dr
Jacksonville, TX 75766-2519 - Phone
- (903) 586-1551
- Fax
- (903) 586-1552
- NPI assigned
- Jul 23, 2015
- Organization subpart
- No
Authorized official
- Name
- Wyatt Seth Checketts, DDS
- Title
- Owner/Dentist
- Phone
- (903) 586-1551
Practitioners 1
-
Michael Dwaine Banks, D.D.S.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 30949 | TX | Yes |
Addresses
Primary practice location
606 Brookside Dr
Jacksonville, TX 75766-2519
Mailing address
606 Brookside Dr
Jacksonville, TX 75766-2519
Phone (903) 586-1551
Other providers in Jacksonville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.