Reddick, Debra M

Reddick, Debra M is an individual health care provider with primary practice located at 4458 Jonesboro Rd , Forest Park GA 30297-4314. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dental Public Health, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Reddick, Debra M can be contacted via phone (470) 878-3512.

Contact Information

Primary practice address
4458 Jonesboro Rd Forest Park GA 30297-4314
Phone: (470) 878-3512
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Public Health 1223D0001X DN013060 Georgia
Dental Providers / General Practice 1223G0001X DN013060 Georgia
Dental Providers / General Practice 1223G0001X DN013060 Georgia

Profile Details

NPI number 1396710901
LBN Legal business name Reddick, Debra M
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 18th, 2006
Last updated Jul 21st, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1396710901 NPPES
Georgia MEDICAID 545055622A
Georgia MEDICAID 545055622B
Georgia MEDICAID 9180174

Popular Providers