Provider Demographics
NPI:1740170448
Name:DELTA PEDIATRIC DENTAL
Entity type:Organization
Organization Name:DELTA PEDIATRIC DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:769-798-0124
Mailing Address - Street 1:1143 CLOVERDALE DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701-8321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1143 CLOVERDALE DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-8321
Practice Address - Country:US
Practice Address - Phone:769-798-0124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental