| Canyon Dental Group, Pllc | |
|
4001 E Broadway Blvd Tucson AZ 85711-3454 | |
| (520) 323-2600 | |
| (520) 323-2800 |
| Full Name | Canyon Dental Group, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 4001 E Broadway Blvd, Tucson, Arizona |
| Authorized Official Name and Position | Berkley Hall (OWNER) |
| Authorized Official Contact | 5203232600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyon Dental Group, Pllc 4001 E Broadway Blvd Tucson AZ 85711-3454 Ph: (520) 323-2600 | Canyon Dental Group, Pllc 4001 E Broadway Blvd Tucson AZ 85711-3454 Ph: (520) 323-2600 |
| NPI Number | 1619363694 |
|---|---|
| Provider Enumeration Date | 04/07/2015 |
| Last Update Date | 04/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619363694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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