Black Canyon City Dentistry LLC

NPI #1639380363 in Black Canyon City, Arizona

Provider Information

NPI Number: 1639380363
Entity Type: Organization
Organization Name: Black Canyon City Dentistry LLC
Primary Specialty: Dentist
Enumeration Date: May 24, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 34501 S OLD BLACK CANYON CITY HIGHWAY
Address 2: SUITE 5
City: Black Canyon City
State: Arizona
ZIP Code: 85324
Phone: (623) 374-0855

Authorized Official

Name: MR. ELDON W JENKINS
Title: OWNER
Phone: (623) 374-0855

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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