Provider Demographics
NPI:1639255532
Name:METTLER AND GREIGO DENTISTS PC
Entity Type:Organization
Organization Name:METTLER AND GREIGO DENTISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:GRIEGO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-487-4870
Mailing Address - Street 1:18001 N 79TH AVE
Mailing Address - Street 2:SUITE B16
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308
Mailing Address - Country:US
Mailing Address - Phone:623-487-4870
Mailing Address - Fax:623-979-8737
Practice Address - Street 1:18001 N 79TH AVE
Practice Address - Street 2:SUITE B16
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308
Practice Address - Country:US
Practice Address - Phone:623-487-4870
Practice Address - Fax:623-979-8737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ3026122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty