| Second Facility Opened | |
|
5185 Peachtree Pkwy Bldg 1200 Ste 201 Norcross GA 30092 | |
| (770) 368-1110 | |
| (770) 368-1114 |
| Full Name | Second Facility Opened |
|---|---|
| Speciality | Dentist |
| Location | 5185 Peachtree Pkwy, Norcross, Georgia |
| Authorized Official Name and Position | Philip K Talley (DENTIST OWNER) |
| Authorized Official Contact | 7703681110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Second Facility Opened 5185 Peachtree Pkwy Bldg 1200 Ste 201 Norcross GA 30092 Ph: (770) 368-1110 | Second Facility Opened 5185 Peachtree Pkwy Bldg 1200 Ste 201 Norcross GA 30092 Ph: (770) 368-1110 |
| NPI Number | 1861403552 |
|---|---|
| Provider Enumeration Date | 08/10/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861403552 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (NU) | Primary |
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