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Boustani Periodontics PC

Company Details

Name: Boustani Periodontics PC
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Activ
Date of Organization in Rhode Island: 05 Aug 2024 (10 months ago)
Identification Number: 001777372
ZIP code: 02906
County: Providence County
Purpose: DENTISTRY
Fictitious names: Providence Periodontics (trading name, 2024-10-28 - )
Principal Address: Google Maps Logo 40 ELMGROVE AVENUE, PROVIDENCE, RI, 02906-4104, USA

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

Agent

Name Role Address
GABRIEL BOUSTANI Agent 40 ELMGROVE AVENUE, PROVIDENCE, RI, 02906, USA

INCORPORATOR

Name Role Address
GABRIEL BOUSTANI INCORPORATOR 140 GREENWOOD ST NEWTON, MA 02459 USA

PRESIDENT

Name Role Address
GABRIEL BOUSTANI PRESIDENT 40 ELMGROVE AVENUE PROVIDENCE, RI 02906-4104 USA

National Provider Identifier

NPI Number:
1114745155
Certification Date:
2024-09-30

Authorized Person:

Name:
DR. GABRIEL BOUSTANI
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
1223P0300X - Periodontist
Is Primary:
Yes

Contacts:

Fax:
4014210066

Filings

Number Name File Date
202460833370 Fictitious Business Name Statement 2024-10-28
202458581050 Articles of Incorporation 2024-08-05
202566729630 Annual Report 2025-03-11

Date of last update: 16 May 2025

Sources: Rhode Island Department of State