| Greenridge Dental Care | |
|
3215 Green Ridge Dr San Angelo TX 76904-6425 | |
| (325) 942-1616 | |
| (325) 942-6465 |
| Full Name | Greenridge Dental Care |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3215 Green Ridge Dr, San Angelo, Texas |
| Authorized Official Name and Position | Clayton Runyan (CO-OWNER) |
| Authorized Official Contact | 3252612798 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenridge Dental Care 2425 Antilley Rd Abilene TX 79606-5100 Ph: (325) 244-2434 | Greenridge Dental Care 3215 Green Ridge Dr San Angelo TX 76904-6425 Ph: (325) 942-1616 |
| NPI Number | 1053025023 |
|---|---|
| Provider Enumeration Date | 01/13/2023 |
| Last Update Date | 01/13/2023 |
| Certification Date | 01/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053025023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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