Individual
DR. KATHLEEN RUTH FADLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
313 MOOTY BRIDGE RD STE 202, LAGRANGE, GA 30240-1809
(706) 837-0123
Mailing address
140 N DAVIS RD APT 922, LAGRANGE, GA 30241-1616
(678) 860-6792
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN015912
GA
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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