Individual
DR. KATHRYN RICKS MARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
23 RD MEDICAL GROUP, 3278 MITCHELL BLVD, MOODY A F B, GA 31699-1500
(229) 257-3136
Mailing address
4414 WOOD HOLLOW CIR, VALDOSTA, GA 31605-6625
(517) 582-2335
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901020308
MI
Other
Enumeration date
10/04/2010
Last updated
04/14/2014
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