Organization
DR KIM BRADLEY HOOD DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM BRADLEY HOOD DMD PC (PRES OWNER)
(912) 449-6310
Entity
Organization
Contact information
Practice address
643 EAST MAIN STREET, BLACKSHEAR, GA 31516
(912) 449-6310
(912) 449-0009
Mailing address
643 EAST MAIN STREET, BLACKSHEAR, GA 31516
(912) 449-6310
(912) 449-0009
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN010794
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
839938
UNITED CONCORDIA INS
—
Enumeration date
11/21/2006
Last updated
08/22/2020
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