Canon Kids Dental & Braces, PC

NPI #1003776097 in Canon City, Colorado

Provider Information

NPI Number: 1003776097
Entity Type: Organization
Organization Name: Canon Kids Dental & Braces, PC
Primary Specialty: Dentist
Enumeration Date: Nov 13, 2025
Last Updated: Nov 13, 2025

Practice Location

Address: 1201 ROYAL GORGE BLVD
City: Canon City
State: Colorado
ZIP Code: 81212-3835
Phone: (719) 285-0994

Authorized Official

Name: ENJOLI GUILLORY
Title: DIRECTOR OF RCM
Phone: (719) 464-0753

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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