PERIODONTAL ASSOCIATES PC
Dentist at Phoenix Blvd, Atlanta, GA

License number
Georgia 6518
Category
Dentist
Type
Periodontics
Owner
Name: DR. HENRY LEON DIVERSI JR. DMD MSD
Title: PRESIDENT
Phone: (770) 996-2900
Address
Address
1895 Phoenix Blvd STE 138, Atlanta, GA 30349
National Provider ID: 1184845273
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PERIODONTAL ASSOCIATES, PC

1895 Phoenix Blvd SUITE 138, Atlanta, GA 30349

Industry:
Dentist's Office, Business Services
Doing business as:
Periodontal Associates<br>Diversi, Jennifer DMD
Registration:
May 1, 1970
Phone:
(770) 996-2900 (Phone)
State ID:
H002390
Business type:
Domestic Profit Corporation
President, Principals:
L H Diversi (CEO), 1895 Phoenix Blvd STE 138, Atlanta, GA 30349 (Physical),D Mary Hanks (Secretary), 1895 Phoenix Blvd STE 138, Atlanta, GA 30349 (Physical),H. L. Diversi (Owner),...
Agent:
Bill Lankford,780 Johnson Fry Rd STE 325, Atlanta, GA (Physical)
Categories:
Dentist - Periodontist

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