Individual
DR. RAYMOND CHARLES DICKEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
117 FIRST NATIONAL DR, DALLAS, GA 30157-3430
(770) 672-5629
Mailing address
85 GOLF CREST DR STE 209, ACWORTH, GA 30101-2698
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN014642
GA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
2019013206
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2013
Last updated
07/08/2024
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