Canyon Modern Dentistry & Orthodontics

NPI #1366848897 in Surprise, Arizona

Provider Information

NPI Number
1366848897
Entity Type
Organization
Organization Name
Canyon Modern Dentistry & Orthodontics
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Nov 11, 2014
Last Updated
Nov 11, 2014

Practice Location

Address
17081 W GREENWAY RD
Address 2
SUITE 120
State
Arizona
ZIP Code
85388-9612
Phone
(623) 546-8400

Authorized Official

Name
DR. MOHAMMED REZA KHAKWANI, DMD
Title
GENERAL DENTIST
Phone
(316) 727-6886

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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