| Little Peaches Pediatric Dentistry | |
|
120 Handley Rd Suite 210 Tyrone GA 30290-2177 | |
| (770) 632-7090 | |
| (770) 632-7075 |
| Full Name | Little Peaches Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 120 Handley Rd, Tyrone, Georgia |
| Authorized Official Name and Position | Charisse Caswell (OWNER) |
| Authorized Official Contact | 7706327090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Little Peaches Pediatric Dentistry 120 Handley Rd Suite 210 Tyrone GA 30290-2177 Ph: (770) 632-7090 | Little Peaches Pediatric Dentistry 120 Handley Rd Suite 210 Tyrone GA 30290-2177 Ph: (770) 632-7090 |
| NPI Number | 1801246079 |
|---|---|
| Provider Enumeration Date | 06/17/2016 |
| Last Update Date | 06/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801246079 | NPI | - | NPPES |
| 773054619H | Medicaid | GA | |
| 773054619G | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN013163 (Georgia) | Primary |
Nova Dental, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1134 Senoia Rd Ste A2, Tyrone, GA 30290 Phone: 770-253-5885 | |
Carlos Ramos Dmd; Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 155 Handley Rd, Tyrone, GA 30290 Phone: 770-632-0264 | |
Georgia Dental Professionals, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1522 Highway 74 N, Tyrone, GA 30290 Phone: 678-788-8050 |