| Canyon Family Dental Llc | |
|
500 N Estrella Pkwy Ste B1 Goodyear AZ 85338-4136 | |
| (623) 880-0782 | |
| Not Available |
| Full Name | Canyon Family Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 500 N Estrella Pkwy Ste B1, Goodyear, Arizona |
| Authorized Official Name and Position | Faith Gaskins (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 9728693789 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyon Family Dental Llc 500 N Estrella Pkwy Ste B1 Goodyear AZ 85338-4136 Ph: (623) 880-0782 | Canyon Family Dental Llc 500 N Estrella Pkwy Ste B1 Goodyear AZ 85338-4136 Ph: (623) 880-0782 |
| NPI Number | 1982245676 |
|---|---|
| Provider Enumeration Date | 10/03/2019 |
| Last Update Date | 10/03/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982245676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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