# ROBERTS, WALLACE & ASSOCIATES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Triad Kids Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104203579
- **Authorized official:** TERESA ZWICKY (CREDENTIALING MANAGER)
- **Authorized official phone:** (480) 866-8811

## Contact information

- **Practice address:** 5069 UNIVERSITY PKWY \# 11, WINSTON SALEM, NC 27106-6083
- **Practice address phone:** (336) 714-5726
- **Practice address fax:** (336) 792-4202
- **Mailing address:** 5069 UNIVERSITY PKWY, 11, WINSTON SALEM, NC 27106-6083
- **Mailing address phone:** (336) 714-5726
- **Mailing address fax:** (336) 792-4202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 9846 | NC | Yes |

## Other

- **Enumeration date:** 05/05/2015
- **Last updated:** 08/15/2025