| NPI | 1730397340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY GAIL REDICK Dentist,Owner 912-826-1905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012371) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2012-08-23 |