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Individual

DR. ANDREW KICKLIGHTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
3208 US HIGHWAY 41 N, BYRON, GA 31008-3721
(478) 953-7770
Mailing address
2122 BETHEL RD, SYCAMORE, GA 31790-2814
(229) 567-4295

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN015421
GA

Other

Enumeration date
07/07/2017
Last updated
07/07/2017
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