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3180 N Point Pkwy Ste 522 Alpharetta GA 30005-4569 | |
| (470) 719-5181 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3180 N Point Pkwy Ste 522, Alpharetta, Georgia |
| Authorized Official Name and Position | Gustave Joseph Peluso (OWNER) |
| Authorized Official Contact | 4044057756 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3180 N Point Pkwy Ste 522 Alpharetta GA 30005-4569 Ph: (470) 719-5181 | 3180 N Point Pkwy Ste 522 Alpharetta GA 30005-4569 Ph: (470) 719-5181 |
| NPI Number | 1114405511 |
|---|---|
| Provider Enumeration Date | 07/30/2018 |
| Last Update Date | 07/30/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114405511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN011882 (Georgia) | Primary |
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