Second Facility Opened | |
5185 Peachtree Pkwy Bldg 1200 Ste 201 Norcross GA 30092 | |
(770) 368-1110 | |
(770) 368-1114 |
Full Name | Second Facility Opened |
---|---|
Speciality | Dentist |
Location | 5185 Peachtree Pkwy, Norcross, Georgia |
Authorized Official Name and Position | Philip K Talley (DENTIST OWNER) |
Authorized Official Contact | 7703681110 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Second Facility Opened 5185 Peachtree Pkwy Bldg 1200 Ste 201 Norcross GA 30092 Ph: (770) 368-1110 | Second Facility Opened 5185 Peachtree Pkwy Bldg 1200 Ste 201 Norcross GA 30092 Ph: (770) 368-1110 |
NPI Number | 1861403552 |
---|---|
Provider Enumeration Date | 08/10/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861403552 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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