OrganizationActive
Tebo Dentistry for Kids Peachtree Corners, LLC
NPI 1083172035 · Dental Clinic/Center · Peachtree Corners, GA
Provider details
- NPI number
- 1083172035
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Mark Thebaut, President/Owner(770) 925-3300
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6460 Spalding Drive
Suite C
Peachtree Corners, GA 30092
Phone: (770) 925-3300
Street-level locationGet directions
Mailing address
Po Box 1953
Lilburn, GA 30048
Other names (DBA / former)
- Doing business as
- Tebo Dentistry for Kids Peachtree Corners
Registry dates
- Enumerated
- 2019-03-08
- Last updated
- 2019-06-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.