| Canyon Dental | |
|
2219 S Hacienda Blvd Ste 202 Hacienda Heights CA 91745-4610 | |
| (626) 369-8617 | |
| (626) 369-0257 |
| Full Name | Canyon Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2219 S Hacienda Blvd Ste 202, Hacienda Heights, California |
| Authorized Official Name and Position | Gabriel De La Vara (DENTIST) |
| Authorized Official Contact | 6263698617 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyon Dental 2219 S Hacienda Blvd Ste 202 Hacienda Heights CA 91745-4610 Ph: (626) 369-8617 | Canyon Dental 2219 S Hacienda Blvd Ste 202 Hacienda Heights CA 91745-4610 Ph: (626) 369-8617 |
| NPI Number | 1922599240 |
|---|---|
| Provider Enumeration Date | 05/22/2018 |
| Last Update Date | 05/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922599240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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