Individual
DR. RICO SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
577 CONCORD RD SE, SUITE A, SMYRNA, GA 30082-2609
(678) 503-0790
(678) 509-0792
Mailing address
577 CONCORD RD SE, SUITE A, SMYRNA, GA 30082-2609
(678) 503-0790
(678) 509-0792
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN012031
GA
Other
Enumeration date
07/17/2006
Last updated
07/08/2007
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