| Canyon River Dental | |
|
3707 N Canyon Rd Suite 7d Provo UT 84604-4592 | |
| (801) 221-5859 | |
| (801) 221-7091 |
| Full Name | Canyon River Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3707 N Canyon Rd, Provo, Utah |
| Authorized Official Name and Position | Mark C Lomenick (CFO) |
| Authorized Official Contact | 8012215859 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyon River Dental 3707 N Canyon Rd Suite 7d Provo UT 84604-4592 Ph: (801) 221-5859 | Canyon River Dental 3707 N Canyon Rd Suite 7d Provo UT 84604-4592 Ph: (801) 221-5859 |
| NPI Number | 1306277546 |
|---|---|
| Provider Enumeration Date | 12/12/2013 |
| Last Update Date | 12/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306277546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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