Organization
SOUTHERN PEACH DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MCKELLAR (CFO)
(678) 794-6966
Entity
Organization
Contact information
Practice address
171 CLEVELAND AVE SW, ATLANTA, GA 30315-8258
(678) 794-6966
Mailing address
171 CLEVELAND AVE SW, ATLANTA, GA 30315-8258
(678) 794-6966
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/22/2025
Last updated
11/22/2025
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