Organization
PERIODONTAL SPECIALISTS OF VININGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUSAM BEZREH DMD, MS, ABP (OWNER)
(678) 677-9288
Entity
Organization
Contact information
Practice address
100 GALLERIA PKWY SE, SUITE 250, ATLANTA, GA 30339-3179
(678) 236-0500
(678) 236-0586
Mailing address
100 GALLERIA PKWY SE, SUITE 250, ATLANTA, GA 30339-3179
(678) 236-0500
(678) 236-0586
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
GA
Other
Enumeration date
11/03/2014
Last updated
07/18/2023
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