Individual
MRS. KIMBERLY GAIL REDICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
131 SILVERWOOD COMMERCIAL DR SUITE #400, RINCON, GA 31326-5131
(912) 826-1905
(912) 826-1171
Mailing address
131 SILVERWOOD COMMERCIAL DR SUITE #400, RINCON, GA 31326-5131
(912) 826-1905
(912) 826-1171
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
012371
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1819395
UNITED CONCORDIA
GA
Enumeration date
01/30/2007
Last updated
08/23/2012
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