Individual
KERMIT J MALLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
201 CROSSTOWN DR APT 1020, PEACHTREE CITY, GA 30269-3457
(228) 547-5977
Mailing address
201 CROSSTOWN DR APT 1020, PEACHTREE CITY, GA 30269-3457
(228) 547-5977
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012289
GA
Other
Enumeration date
05/28/2008
Last updated
02/22/2010
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