# ROBERTS, WALLACE & ASSOCIATES PLLC

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

## Provider details

- **NPI number:** 1578054557
- **Authorized official:** TERESA ZWICKY (CREDENTIALING MANAGER)
- **Authorized official phone:** (480) 866-8811

## Contact information

- **Practice address:** 2643 RANDLEMAN RD, GREENSBORO, NC 27406-5153
- **Practice address phone:** (336) 544-2758
- **Practice address fax:** (910) 338-3031
- **Mailing address:** 2643 RANDLEMAN RD, GREENSBORO, NC 27406-5153
- **Mailing address phone:** (480) 866-8811

## Taxonomy

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

## Other

- **Enumeration date:** 05/24/2018
- **Last updated:** 08/15/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1689746232 | — | NC |