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General NPI Number Information
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NPI Number | 1316111057
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Entity Type | Organization
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Legal Business Name | GENERAL DENTISTRY FOR KIDS-GREENWAY PLLC
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 3202 E GREENWAY RD STE 1287
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City | PHOENIX
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State | AZ
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Zip | 85032-4550
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Country | US
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Telephone | 602-996-6065
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Fax | 602-996-6068
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Provider Business Mailing Address
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Address Line | 3202 E GREENWAY RD STE 1287
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City | PHOENIX
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State | AZ
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Zip | 85032-4550
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Country | US
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Telephone | 602-996-6065
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Fax | 602-429-8638
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | MRS. TERESA ZWICKY
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Credential |
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Telephone | 480-866-8811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D4964
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License Number State | AZ
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