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Individual

PETER JOHN GEORGIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
16835 ALKALI DR, SUITE M, LEMOORE, CA 93245-9463
(559) 924-0460
(559) 924-2197
Mailing address
2263 W BIRCH AVE, FRESNO, CA 93711-0442
(559) 431-8515
(559) 227-2880

Taxonomy

Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
CA26640
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
26640
CA
Enumeration date
08/12/2006
Last updated
07/08/2007
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