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Kennestone Periodontics Of Marietta, Pc
Periodontist in Marietta, Georgia
NPI 1316243389

Kennestone Periodontics Of Marietta, Pc is a Periodontist based in Atlanta, GA and is specialized in Periodontics. Kennestone Periodontics Of Marietta, Pc practices in Marietta, GA. The NPI Number for Kennestone Periodontics Of Marietta, Pc is 1316243389 and holds a License No. 11384 (Georgia).

The current practice location address for Kennestone Periodontics Of Marietta, Pc is 611 Campbell Hill St Nw, Marietta, GA and can be reached out via phone at 770-422-0642 and via fax at 770-422-0643. You can also correspond with Kennestone Periodontics Of Marietta, Pc through the mailing address at 2070 S PARK PL SE, ATLANTA, GA - 30339-2045 (mailing address contact number: 770-952-5432).

Location: 611 Campbell Hill St Nw, Marietta, GA, 30339-2045
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1316243389
Provider Name
Kennestone Periodontics Of Marietta, Pc
Credential
Provider Entity Type
Organization
Address
611 Campbell Hill St Nw, Marietta, GA, 30339-2045
Phone Number
770-422-0642
Fax Number
770-422-0643
Provider Enumeration Date
02/08/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1982798716 01 GA PERSONAL NPI NUMBER
1811082183 01 GA PERSONAL NPI NUMBER
institution
Provider Business Practice Location Address Details
Address
611 Campbell Hill St Nw
City
Marietta
State
Georgia
Zip
30060-1386
Phone Number
770-422-0642
Fax Number
770-422-0643
person
Provider Business Mailing Address Details
Address
611 Campbell Hill St Nw
City
Marietta
State
Georgia
Zip
30060-1386
Phone Number
770-422-0642
Fax Number
770-422-0643
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Periodontics
Taxonomy
1223P0300X
License No.
11384 (Georgia)
Definition
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.
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