# GREENFIELD DENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558793430
- **Authorized official:** DR. BRANNON JAY GUNNELL DDS (OWNER)
- **Authorized official phone:** (480) 832-5190

## Contact information

- **Practice address:** 107 N. GREENFIELD RD., STE. \#2, MESA, AZ 85205-7802
- **Practice address phone:** (480) 832-5190
- **Practice address fax:** (480) 654-9900
- **Mailing address:** 107 N GREENFIELD RD, SUITE 2, MESA, AZ 85205-7802
- **Mailing address phone:** (480) 832-5190
- **Mailing address fax:** (480) 654-9900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2564 | AZ | — |
| 122300000X | Dentist | 7304 | AZ | — |
| 122300000X | Dentist | 7577 | AZ | — |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 08/02/2013
- **Last updated:** 08/02/2013