| NPI | 1235800897 | 
|---|---|
| Doing Business As | GREENVILLE KIDS DENTAL | 
| Entity Type | Organization | 
| Authorized Contact | TERESA ZWICKY Credentialing & Enrollment Manager 480-866-8811  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Enumeration Date | 2021-09-23 | 
| Last Update Date | 2025-08-15 |