Individual
DR. RICHARD W. KINSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
6043 PRESTLEY MILL RD, SUITE A, DOUGLASVILLE, GA 30134-2280
(770) 949-3797
(770) 949-9077
Mailing address
6043 PRESTLEY MILL RD, SUITE A, DOUGLASVILLE, GA 30134-2280
(770) 949-3797
(770) 949-9077
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
009063
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009063
DENTAL LICENSE
GA
Enumeration date
12/18/2006
Last updated
01/07/2016
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