| NPI | 1750506036 |
|---|---|
| Doing Business As | PEACH TREE DENTAL |
| Entity Type | Organization |
| Authorized Contact | TROY KENDALL SLADE Dentist/Owner 805-544-7804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 58800) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 62898) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2014-08-04 |