Organization
GREENWAY DENTAL LAB INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW FRKETICH (OWNER)
(602) 242-2303
Entity
Organization
Contact information
Practice address
1855 W GREENWAY RD STE 109, PHOENIX, AZ 85023-3475
(602) 242-2303
Mailing address
1855 W GREENWAY RD STE 109, PHOENIX, AZ 85023-3475
(602) 242-2303
Taxonomy
Speciality
Code
Description
License number
State
126900000X
Dental Laboratory Technician
Primary
—
—
Other
Enumeration date
09/07/2019
Last updated
09/07/2019
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