Provider Demographics
NPI:1619948056
Name:BIETHMAN, RICK K (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:K
Last Name:BIETHMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 ROBERT E LEE LN
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29909-4425
Mailing Address - Country:US
Mailing Address - Phone:618-954-6116
Mailing Address - Fax:
Practice Address - Street 1:674 BLVD DE FRANCE
Practice Address - Street 2:DENTAL CLINIC
Practice Address - City:PARRIS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29905-0000
Practice Address - Country:US
Practice Address - Phone:843-228-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice