| 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 |
|---|---|
| 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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