Individual
DR. RONALD J POLK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3408 UNIVERSITY AVE, STE B, COLUMBUS, GA 31907
(706) 563-5516
(706) 563-5575
Mailing address
3408 UNIVERSITY AVE, STE B, COLUMBUS, GA 31907
(706) 563-5516
(706) 563-5575
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011350
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045607
UNITED CONCORDIA
—
01
—
F0076
BLUE CROSS OF LA
—
Enumeration date
11/27/2006
Last updated
07/08/2007
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