| NPI | 1053025023 |
|---|---|
| Doing Business As | GREENRIDGE DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | CLAYTON RUNYAN Co Owner 325-261-2798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-01-13 |
| Last Update Date | 2023-01-13 |