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 |