# ROCK CANYON FAMILY DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376056192
- **Authorized official:** VALERIE HALL (BUSINESS MANAGER)
- **Authorized official phone:** (623) 910-5569

## Contact information

- **Practice address:** 332 S ORCHARD SPRINGS DR STE 110, PUEBLO WEST, CO 81007-6154
- **Practice address phone:** (719) 924-8858
- **Mailing address:** 4542 VALLEYBROOK DR, HIGHLANDS RANCH, CO 80130-6965

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 202339 | CO | Yes |

## Other

- **Enumeration date:** 11/15/2017
- **Last updated:** 11/15/2017