Individual
DR. THEODORE D RAVENEL V
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 30912-0001
(706) 721-2371
(706) 721-6778
Mailing address
1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 30912-0001
(706) 721-2371
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
3711
SC
1223E0200X
Endodontics
Primary
DNF000463
GA
Other
Enumeration date
12/19/2006
Last updated
07/02/2024
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