Canyon Modern Dentistry | |
17081 W Greenway Rd Ste 121 Surprise AZ 85388-9612 | |
(623) 546-8400 | |
(623) 214-5830 |
Full Name | Canyon Modern Dentistry |
---|---|
Speciality | Dentist - General Practice |
Location | 17081 W Greenway Rd Ste 121, Surprise, Arizona |
Authorized Official Name and Position | James B Mallory (OWNER DOCTOR) |
Authorized Official Contact | 6235468400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Canyon Modern Dentistry 2860 Michelle Drive 2nd Floor Irvine CA 92606 Ph: (714) 368-2077 | Canyon Modern Dentistry 17081 W Greenway Rd Ste 121 Surprise AZ 85388-9612 Ph: (623) 546-8400 |
NPI Number | 1194021170 |
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Provider Enumeration Date | 02/08/2011 |
Last Update Date | 02/08/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194021170 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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