| NPI | 1285860155 |
|---|---|
| Doing Business As | PEACH STATE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | VAL KOLPAKOV Owner 770-569-5333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN013657) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2009-06-05 |