NPI | 1033849997 |
---|---|
Doing Business As | GREENVILLE AVENUE DENTISTRY |
Entity Type | Organization |
Authorized Contact | ALI SHAHRESTANI Owner 864-565-7132 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2022-06-14 |
Last Update Date | 2022-06-14 |