Organization
DENTAL DEPOT ORTHO GREENWAY PLLC
Active
Organization
DENTAL DEPOT ORTHO GREENWAY PLLC
Active
Other names
Glenn A Ashmore DDS Sole MBR
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH MARTINEZ (REGIONAL MANAGER)
(602) 312-2752
Entity
Organization
Contact information
Practice address
3750 W GREENWAY RD, PHOENIX, AZ 85053-3703
(602) 466-2202
Mailing address
2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
(602) 312-2752
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
02/25/2021
Last updated
02/25/2021
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