PEACH STATE DENTAL IMPLANTS AND PERIODONTICS NPI 1740956572

NPI Information

  • NPI: 1740956572
  • Provider Name: PEACH STATE DENTAL IMPLANTS AND PERIODONTICS
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Organization
  • Address: 4300 WESTBROOK RD # F
    SUWANEE, GA
    ZIP 30024
  • Phone: (770) 310-7822

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NPI Details

PEACH STATE DENTAL IMPLANTS AND PERIODONTICS is a periodontics dentist in Suwanee, GA. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. PEACH STATE DENTAL IMPLANTS AND PERIODONTICS NPI is 1740956572. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4300 WESTBROOK RD # F
SUWANEE, GA
ZIP 30024-987
Phone: (770) 310-7822

The provider's authorized official is Malissa Nicole Gianfala .
The authorized official title is Hr/operations Manager and has the following contact phone number (770) 500-8446.

The enumeration date for this NPI number is 8/20/2021 and was last updated on 8/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0300XDentistPeriodonticsYes

What is NPI?

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This page was last updated on: 3/30/2025

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