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02906
Periodontics, Inc.

Periodontics, Inc.

Company Details

Name:	Periodontics, Inc.
Jurisdiction:	Rhode Island
Entity type:	Domestic Profit Corporation
Status:	Activ
Date of Organization in Rhode Island:	02 Jan 1969 (56 years ago)
Identification Number:	000010073
ZIP code:	02906
County:	Providence County
Principal Address:	167 GANO STREET, PROVIDENCE, RI, 02906, USA
Purpose:	PERIODONTAL PRACTICE
Historical names:	Periodontal Associates, Inc. Drs. Paul L. Segal and Daniel P. DeCesare, Inc.

Industry & Business Activity

NAICS

621210 Offices of Dentists

This industry comprises establishments of health practitioners having the degree of D.M.D. (Doctor of Dental Medicine), D.D.S. (Doctor of Dental Surgery), or D.D.Sc. (Doctor of Dental Science) primarily engaged in the independent practice of general or specialized dentistry or dental surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. They can provide either comprehensive preventive, cosmetic, or emergency care, or specialize in a single field of dentistry. Learn more at the U.S. Census Bureau

National Provider Identifier

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1841398658

2006-09-20

2020-08-22

167 GANO STREET, PROVIDENCE, RI, 02906, US

Contacts

Phone	+1 401-274-2600
Fax	4014217875

Authorized person

Name	DR. SCOTT M FERTIK
Role	PRESIDENT
Phone	4012742600

Taxonomy

Taxonomy Code	122300000X - Dentist
License Number	DEN02345
State	RI
Is Primary	Yes
Taxonomy Code	122300000X - Dentist
License Number	DEN02700
State	RI
Is Primary	No
Taxonomy Code	122300000X - Dentist
License Number	DEN01328
State	RI
Is Primary	No

Agent

Name	Role	Address
E. COLBY CAMERON, ESQ.	Agent	301 PROMENADE STREET, PROVIDENCE, RI, 02908, USA

PRESIDENT

Name	Role	Address
SCOTT M. FERTIK, DDS	PRESIDENT	167 GANO STREET PROVIDENCE, RI 02906 USA

VICE PRESIDENT

Name	Role	Address
JOHN G. BRODERICK DMD	VICE PRESIDENT	167 GANO STREET PROVIDENCE, RI 02906 USA

DIRECTOR

Name	Role	Address
SCOTT M. FERTIK DDS	DIRECTOR	167 GANO STREET PROVIDENCE, RI 02906 USA
JOHN G. BRODERICK DMD	DIRECTOR	167 GANO STREET PROVIDENCE, RI 02906 USA

Events

Type	Date	Old Value	New Value
Name Change	1995-01-09	Drs. Paul L. Segal and Daniel P. DeCesare, Inc.	Periodontics, Inc.
Name Change	1971-01-25	Periodontal Associates, Inc.	Drs. Paul L. Segal and Daniel P. DeCesare, Inc.

Filings

Number	Name	File Date
202448882600	Annual Report	2024-03-19
202333230310	Annual Report	2023-04-18
202216986770	Annual Report	2022-05-06
202191256820	Annual Report	2021-02-10
202035448680	Annual Report	2020-02-25
201986617660	Annual Report	2019-02-13
201857745010	Annual Report	2018-02-05
201731367800	Annual Report	2017-02-02
201691899980	Annual Report	2016-02-04
201556984170	Annual Report	2015-03-11
201436984500	Annual Report	2014-03-11
201313884350	Annual Report	2013-03-13
201291272660	Annual Report	2012-03-20
201174613160	Annual Report	2011-02-08
201059973040	Annual Report	2010-03-05
200943771180	Annual Report	2009-03-09
200942486760	Statement of Change of Registered/Resident Agent Office	2009-02-20
200837726630	Annual Report	2008-11-18
200837726540	Reinstatement	2008-11-18
200837726810	Statement of Change of Registered/Resident Agent	2008-11-18

Paycheck Protection Program

Loan Number

Loan Funded Date

SBA Origination Office Code

Loan Delivery Method

Borrower Street Address

4591287802

2020-05-28

0165

PPP

167 GANO ST, PROVIDENCE, RI, 02906-3808

Loan Status Date	2021-03-17
Loan Status	Paid in Full
Loan Maturity in Months	24
SBA Guaranty Percentage	100
Loan Approval Amount (at origination)	130000
Loan Approval Amount (current)	130000
Undisbursed Amount	0
Franchise Name	-
Lender Location ID	434162
Servicing Lender Name	Citizens Bank, National Association
Servicing Lender Address	1 Citizens Plaza, PROVIDENCE, RI, 02903-1344
Rural or Urban Indicator	U
Hubzone	N
LMI	N
Business Age Description	Existing or more than 2 years old
Project Address	PROVIDENCE, PROVIDENCE, RI, 02906-3808
Project Congressional District	RI-01
Number of Employees	14
NAICS code	621210
Borrower Race	Unanswered
Borrower Ethnicity	Unknown/NotStated
Business Type	Corporation
Originating Lender ID	434162
Originating Lender Name	Citizens Bank, National Association
Originating Lender Address	PROVIDENCE, RI
Gender	Unanswered
Veteran	Unanswered
Forgiveness Amount	130943.84
Forgiveness Paid Date	2021-02-23

5052588310

2021-01-23

0165

PPS

167 Gano St, Providence, RI, 02906-3808

Loan Status Date	2021-10-22
Loan Status	Paid in Full
Loan Maturity in Months	60
SBA Guaranty Percentage	100
Loan Approval Amount (at origination)	130000
Loan Approval Amount (current)	130000
Undisbursed Amount	0
Franchise Name	-
Lender Location ID	434162
Servicing Lender Name	Citizens Bank, National Association
Servicing Lender Address	1 Citizens Plaza, PROVIDENCE, RI, 02903-1344
Rural or Urban Indicator	U
Hubzone	N
LMI	N
Business Age Description	Existing or more than 2 years old
Project Address	Providence, PROVIDENCE, RI, 02906-3808
Project Congressional District	RI-01
Number of Employees	14
NAICS code	621210
Borrower Race	Unanswered
Borrower Ethnicity	Unknown/NotStated
Business Type	Corporation
Originating Lender ID	434162
Originating Lender Name	Citizens Bank, National Association
Originating Lender Address	PROVIDENCE, RI
Gender	Unanswered
Veteran	Unanswered
Forgiveness Amount	130808.49
Forgiveness Paid Date	2021-09-10

Date of last update: 06 Apr 2025

Sources: Rhode Island Department of State