Provider Demographics
NPI:1316640196
Name:RICE, VICTORIA MICHELE (DMD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MICHELE
Last Name:RICE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:779 LIGHTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HARTWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30643-4007
Mailing Address - Country:US
Mailing Address - Phone:706-424-7471
Mailing Address - Fax:
Practice Address - Street 1:3112 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-2763
Practice Address - Country:US
Practice Address - Phone:803-590-3054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1230951223G0001X
SCDGD.105451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice