Organization
PEACHTREE HILLS PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHELL VAUGHAN DDS (PRESIDENT)
(404) 750-4442
Entity
Organization
Contact information
Practice address
2385 PEACHTREE RD NE STE A2AB, ATLANTA, GA 30305-4139
(404) 750-4442
Mailing address
2385 PEACHTREE RD NE STE A2AB, ATLANTA, GA 30305-4139
(404) 750-4442
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598803868
INDIVIDUAL NPI
—
Enumeration date
10/04/2019
Last updated
10/04/2019
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