Organization
PEACHTREE CHILDREN'S DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAMEUN NANCY KIL DDS (DOCTOR/BUSINESS OWNER)
(770) 497-0110
Entity
Organization
Contact information
Practice address
3820 PLEASANT HILL RD, SUITE 1, DULUTH, GA 30096
(770) 497-0110
(770) 497-0580
Mailing address
3820 PLEASANT HILL RD, SUITE 1, DULUTH, GA 30096
(770) 497-0110
(770) 497-0580
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
DNO12519
GA
1223P0221X
Pediatric Dentistry
Primary
DNO12595
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000947944B
—
GA
05
—
000949616B
—
GA
Enumeration date
03/18/2008
Last updated
06/14/2019
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