# TARA DERMATOLOGY CENTER PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vincent T Peng MD PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699892380
- **Authorized official:** DR. VINCENT PENG (PHYSICIAN)
- **Authorized official phone:** (770) 991-1000

## Contact information

- **Practice address:** 191 MEDICAL BLVD, STOCKBRIDGE, GA 30281-5083
- **Practice address phone:** (770) 991-1000
- **Mailing address:** 191 MEDICAL BLVD, STOCKBRIDGE, GA 30281-5083
- **Mailing address phone:** (770) 991-1000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | GA | Yes |

## Other

- **Enumeration date:** 03/26/2007
- **Last updated:** 03/26/2013