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Organization
PEACH STATE DENTAL IMPLANTS AND PERIODONTICS
Active
Organization
PEACH STATE DENTAL IMPLANTS AND PERIODONTICS
Active
Other names
Peach State Laser Periodontics & Implants
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MALISSA NICOLE GIANFALA (HR/OPERATIONS MANAGER)
(770) 500-8446
Entity
Organization
Contact information
Practice address
4300 WESTBROOK RD # F, SUWANEE, GA 30024-4987
(770) 310-7822
Mailing address
4300 WESTBROOK RD # F, SUWANEE, GA 30024-4987
(770) 310-7822
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
08/20/2021
Last updated
08/20/2021
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