Individual
DR. FREDRICO ALBERT DIXON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7218 HIGHWAY 85, RIVERDALE, GA 30274-2908
(404) 593-3404
(404) 228-9673
Mailing address
7218 HIGHWAY 85, RIVERDALE, GA 30274-2908
(404) 593-3404
(404) 228-9673
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN014566
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003134944F
—
GA
01
—
4127424
BLUE CROSS/BLUE SHIELD
TN
01
—
510DN
BCBS
AL
Enumeration date
10/26/2006
Last updated
05/23/2020
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