Organization
PEACH DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THU VU (DDS)
(770) 256-7555
Entity
Organization
Contact information
Practice address
3596 W HILL ST # B, CLARKSTON, GA 30021-1205
(770) 256-7555
Mailing address
3596 W HILL ST # B, CLARKSTON, GA 30021-1205
(770) 256-7555
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN012520
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
518280914A
—
GA
Enumeration date
03/07/2007
Last updated
10/18/2016
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