Organization
ROBERTS, WALLACE & ASSOCIATES PLLC
Active
Other names
Triad Kids Dental
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA ZWICKY (CREDENTIALING MANAGER)
(480) 866-8811
Entity
Organization
Contact information
Practice address
2643 RANDLEMAN RD, GREENSBORO, NC 27406-5153
(336) 544-2758
(910) 338-3031
Mailing address
2643 RANDLEMAN RD, GREENSBORO, NC 27406-5153
(480) 866-8811
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9846
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689746232
—
NC
Enumeration date
05/24/2018
Last updated
08/15/2025
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