Canyon Family Dental LLC

NPI #1982245676 in Goodyear, Arizona

Provider Information

NPI Number: 1982245676
Entity Type: Organization
Organization Name: Canyon Family Dental LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 3, 2019
Last Updated: Oct 3, 2019

Practice Location

Address: 500 N ESTRELLA PKWY STE B1
City: Goodyear
State: Arizona
ZIP Code: 85338-4136
Phone: (623) 880-0782

Authorized Official

Name: FAITH GASKINS
Title: DIRECTOR OF CREDENTIALING
Phone: (972) 869-3789

Specialties & Taxonomy Codes

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

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