| Copper Canyon Smiles | |
|
23771 Washington Ave Suite H102 Murrieta CA 92562-2278 | |
| (951) 691-5096 | |
| (951) 691-5097 |
| Full Name | Copper Canyon Smiles |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 23771 Washington Ave, Murrieta, California |
| Authorized Official Name and Position | Crystal Quintero (BILLER) |
| Authorized Official Contact | 9516915096 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Copper Canyon Smiles 23771 Washington Ave Suite H102 Murrieta CA 92562-2278 Ph: (951) 691-5096 | Copper Canyon Smiles 23771 Washington Ave Suite H102 Murrieta CA 92562-2278 Ph: (951) 691-5096 |
| NPI Number | 1669908893 |
|---|---|
| Provider Enumeration Date | 05/09/2017 |
| Last Update Date | 05/09/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669908893 | NPI | - | NPPES |
| 1881095115 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 53453 (California) | Primary |
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