| NPI | 1740956572 | 
|---|---|
| Doing Business As | PEACH STATE LASER PERIODONTICS & IMPLANTS | 
| Entity Type | Organization | 
| Authorized Contact | MALISSA NICOLE GIANFALA Hr/Operations Manager 770-500-8446  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223P0300X Dentist, Periodontics | 
| Enumeration Date | 2021-08-20 | 
| Last Update Date | 2021-08-20 |