Organization
KIMBERLY G REDICK DMD FAMILY AND COSMETIC DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY GAIL REDICK DMD (DENTIST,OWNER)
(912) 826-1905
Entity
Organization
Contact information
Practice address
131 SILVERWOOD COMMERCIAL DR, SUITE #400, RINCON, GA 31326-5131
(912) 826-1905
Mailing address
PO BOX 2406, RINCON, GA 31326-2406
(912) 826-1905
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012371
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1813935
UNITED CONCORDIA
GA
Enumeration date
05/18/2007
Last updated
08/23/2012
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