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Konstantine Dietrich, DDS
General Practice Dentistry in Moody Afb, Georgia
NPI 1023479888

Konstantine Dietrich is a General Practice Dentistry based in Moody Afb, GA and is specialized in General Practice. Konstantine Dietrich practices in Moody Afb, GA and has the professional credentials of DDS. The NPI Number for Konstantine Dietrich is 1023479888 and holds a License No. 0401414848 (Georgia).

The current practice location address for Konstantine Dietrich is 3278 Mitchell Blvd, Moody Afb, GA and can be reached out via phone at 229-257-2778.

Location: 3278 Mitchell Blvd, Moody Afb, GA, 31699-1500
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1023479888
Provider Name
Konstantine Dietrich
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
3278 Mitchell Blvd, Moody Afb, GA, 31699-1500
Phone Number
229-257-2778
Fax Number
Provider Enumeration Date
03/08/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3278 Mitchell Blvd
City
Moody Afb
State
Georgia
Zip
31699-1500
Phone Number
229-257-2778
Fax Number
person
Provider Business Mailing Address Details
Address
3278 Mitchell Blvd
City
Moody Afb
State
Georgia
Zip
31699-1500
Phone Number
229-257-2778
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
0401414848 (Virginia)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
0401414848 (Virginia)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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