| Black Canyon City Dentistry Llc | |
|
34501 S Old Black Canyon City Highway Suite 5 Black Canyon City AZ 85324 | |
| (623) 374-0855 | |
| (623) 374-0854 |
| Full Name | Black Canyon City Dentistry Llc |
|---|---|
| Speciality | Dentist |
| Location | 34501 S Old Black Canyon City Highway, Black Canyon City, Arizona |
| Authorized Official Name and Position | Eldon W Jenkins (OWNER) |
| Authorized Official Contact | 6233740855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Canyon City Dentistry Llc Po Box #7 Black Canyon City AZ 85324 Ph: (623) 374-0855 | Black Canyon City Dentistry Llc 34501 S Old Black Canyon City Highway Suite 5 Black Canyon City AZ 85324 Ph: (623) 374-0855 |
| NPI Number | 1639380363 |
|---|---|
| Provider Enumeration Date | 05/24/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639380363 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 05797 (Arizona) | Primary |
Canyon Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 19251 E Oasis Dr, Black Canyon City, AZ 85324 Phone: 162-344-4232 | |
Radiant Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 19251 E Oasis Dr, Black Canyon City, AZ 85324 Phone: 623-526-2607 |