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DR. KENNETH D PILGRIM DMD

>> Dentist >> Dental Providers

Registrant NPI Number: 1073606703

Individual Registrant:
DR. KENNETH D PILGRIM DMD
Gender: M
Sole Proprietor

Location and contact information for practice:
4787 HAPPY VALLEY ROAD  FLINTSTONE, GA 30725 US
Tel: 706-820-0413  Fax: 706-820-4108

Contact information for business:
P. O. BOX 217 4787 HAPPY VALLEY ROAD FLINTSTONE, GA 30725 US
Tel: 706-820-0413  Fax: 706-820-4108

Registration Information:
NPI: 1073606703
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
GA9189

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
00205158AGA05




HEALTH CARE JOBS GA - Page 1



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