Individual
NICK BRODAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
244 S MAIN ST, REIDSVILLE, GA 30453-4602
(912) 577-6307
Mailing address
244 S MAIN ST, REIDSVILLE, GA 30453-4602
(912) 577-6307
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN123534
GA
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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