Kennestone Periodontics Of Marietta, Pc
Periodontology Clinic
611 Campbell Hill St Nw, Suite 102, Marietta
Georgia, 30060-1386
770-422-0642 770-422-0643
Maps & DirectionsKennestone Periodontics Of Marietta, Pc is a Periodontology Clinic in Marietta, Georgia. It is located at 611 Campbell Hill St Nw, Suite 102, Marietta, GA and its contact number is 770-422-0642. The authorized person for Kennestone Periodontics Of Marietta, Pc is Dr. Peter C Shatz
who is President of the clinic and their contact number is 770-422-0642. The primary license number for Kennestone Periodontics Of Marietta, Pc is 10742 (Periodontics) in Georgia.
Kennestone Periodontics Of Marietta, Pc Clinic is specialized in that branch 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.
Complete Clinic Profile:
Kennestone Periodontics Of Marietta, Pc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Kennestone Periodontics Of Marietta, Pc |
| Specialization: | Periodontology |
| Clinic Address: | 611 Campbell Hill St Nw, Suite 102, Marietta,
Georgia, 30060-1386 |
| Phone: | 770-422-0642 |
| Fax: | 770-422-0643 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Peter C Shatz |
| Position: | President |
| Contact Number: | 770-422-0642 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Kennestone Periodontics Of Marietta, Pc clinic are as mentioned below.
| NPI Number: | 1316243389 |
| NPI Enumeration Date: | 08 Feb, 2011 |
| NPI Last Update On: | 08 Feb, 2011 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kennestone Periodontics Of Marietta, Pc are as mentioned below.
| Specialization | License Number | State | Status | |
| Periodontics | 10742 | Georgia | Primary | |
| Periodontics | 11384 | Georgia | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 1982798716 | Other | Georgia | Personal Npi Number |
| 1811082183 | Other | Georgia | Personal Npi Number |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Kennestone Periodontics Of Marietta, Pc
2070 S Park Pl Se, Suite 200
Atlanta, Georgia |
| Zip: | 30339-2045 |
| Phone Number: | 770-952-5432 |
| Fax Number: | 770-952-3011 |
Patients can reach Kennestone Periodontics Of Marietta, Pc at
611 Campbell Hill St Nw, Suite 102, Marietta, Georgia or can
call to book an appointment on 770-422-0642.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.