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Organization
GREENVILLE AVENUE DENTISTRY, PC
Active
Organization
GREENVILLE AVENUE DENTISTRY, PC
Active
Other names
Greenville Avenue Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ALI SHAHRESTANI DMD (OWNER)
(864) 565-7132
Entity
Organization
Contact information
Practice address
3116 N PLEASANTBURG DR STE 400, GREENVILLE, SC 29609-3757
(864) 565-7132
(864) 568-3813
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8890
(303) 952-0892
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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