Organization
PEACHTREE CHILDREN'S DENTISTRY SNELLVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMARA M COX CDA (OFFICE MANAGER)
(770) 979-6400
Entity
Organization
Contact information
Practice address
1905 SCENIC HWY N STE 510, SNELLVILLE, GA 30078-5635
(770) 979-6400
(770) 979-7465
Mailing address
1905 SCENIC HWY N STE 510, SNELLVILLE, GA 30078-5635
(770) 979-6400
(770) 979-7465
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000947944C
—
GA
05
—
000949616C
—
GA
Enumeration date
01/22/2007
Last updated
04/16/2013
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