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Organization
CANYON VISTA DENTISTRY AND ORTHODONTICS,LLP
Active
Organization
CANYON VISTA DENTISTRY AND ORTHODONTICS,LLP
Active
Other names
Canyon Vista Dentistry and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD R COCKRELL DMD (OWNER DOCTOR)
(626) 561-6767
Entity
Organization
Contact information
Practice address
25155 N 67TH AVE STE 142, PHOENIX, AZ 85083-1065
(626) 561-6767
(623) 561-1703
Mailing address
2860 MICHELLE FL 2, IRVINE, CA 92606-1008
(714) 368-2077
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/10/2010
Last updated
03/10/2010
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