Individual
DR. VICTOR I ETHERIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD,PC
Contact information
Practice address
524 SPARTA RD, SANDERSVILLE, GA 31082-1376
(478) 552-6914
(478) 552-8880
Mailing address
524 SPARTA RD, SANDERSVILLE, GA 31082-1376
(478) 552-6914
(478) 552-8880
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8267
GA
Other
Enumeration date
12/01/2006
Last updated
07/08/2007
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