| Peachtree Children's Dentistry | |
|
3820 Pleasant Hill Rd, Suite 1 Duluth GA 30096 | |
| (770) 497-0110 | |
| (770) 497-0580 |
| Full Name | Peachtree Children's Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3820 Pleasant Hill Rd, Suite 1, Duluth, Georgia |
| Authorized Official Name and Position | Nameun Nancy Kil (DOCTOR/BUSINESS OWNER) |
| Authorized Official Contact | 7704970110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peachtree Children's Dentistry 3820 Pleasant Hill Rd, Suite 1 Duluth GA 30096 Ph: (770) 497-0110 | Peachtree Children's Dentistry 3820 Pleasant Hill Rd, Suite 1 Duluth GA 30096 Ph: (770) 497-0110 |
| NPI Number | 1770754772 |
|---|---|
| Provider Enumeration Date | 03/18/2008 |
| Last Update Date | 06/14/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770754772 | NPI | - | NPPES |
| 000949616B | Medicaid | GA | |
| 000947944B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DNO12595 (Georgia) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | DNO12519 (Georgia) | Secondary |
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