| Peach Blossom Dental, Llc | |
|
2256 Northlake Pkwy Ste 150 Tucker GA 30084-4004 | |
| (770) 934-5144 | |
| (678) 273-3634 |
| Full Name | Peach Blossom Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2256 Northlake Pkwy Ste 150, Tucker, Georgia |
| Authorized Official Name and Position | Angela Dawn Wright (OWNER) |
| Authorized Official Contact | 7709345144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peach Blossom Dental, Llc 2256 Northlake Pkwy Ste 150 Tucker GA 30084-4004 Ph: (770) 934-5144 | Peach Blossom Dental, Llc 2256 Northlake Pkwy Ste 150 Tucker GA 30084-4004 Ph: (770) 934-5144 |
| NPI Number | 1174051908 |
|---|---|
| Provider Enumeration Date | 05/24/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174051908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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