Canyon Modern Dentistry, LLP

NPI #1194021170 in Surprise, Arizona

Provider Information

NPI Number: 1194021170
Entity Type: Organization
Organization Name: Canyon Modern Dentistry, LLP
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 8, 2011
Last Updated: Feb 8, 2011

Practice Location

Address: 17081 W GREENWAY RD STE 121
City: Surprise
State: Arizona
ZIP Code: 85388-9612
Phone: (623) 546-8400

Authorized Official

Name: DR. JAMES B MALLORY JR., DMD
Title: OWNER DOCTOR
Phone: (623) 546-8400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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