| Tebo Dentistry For Kids Peachtree Corners, Llc | |
|
6460 Spalding Drive Suite C Peachtree Corners GA 30092 | |
| (770) 925-3300 | |
| Not Available |
| Full Name | Tebo Dentistry For Kids Peachtree Corners, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6460 Spalding Drive, Peachtree Corners, Georgia |
| Authorized Official Name and Position | Mark Thebaut (PRESIDENT/OWNER) |
| Authorized Official Contact | 7709253300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tebo Dentistry For Kids Peachtree Corners, Llc Po Box 1953 Lilburn GA 30048 Ph: () - | Tebo Dentistry For Kids Peachtree Corners, Llc 6460 Spalding Drive Suite C Peachtree Corners GA 30092 Ph: (770) 925-3300 |
| NPI Number | 1083172035 |
|---|---|
| Provider Enumeration Date | 03/08/2019 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083172035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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