PERIODONTAL SPECIALISTS OF VININGS NPI 1205231271

NPI Information

PERIODONTAL SPECIALISTS OF VININGS is a periodontics dentist in Atlanta, 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. PERIODONTAL SPECIALISTS OF VININGS NPI is 1205231271. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

100 GALLERIA PKWY SE
SUITE 250
ATLANTA, GA
ZIP 30339-179
Phone: (678) 236-0500
Fax: (678) 236-0586

The provider's authorized official is Husam Bezreh .
The authorized official title is Owner and has the following contact phone number (678) 677-9288.

The enumeration date for this NPI number is 11/3/2014 and was last updated on 7/18/2023.

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:

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