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Organization
EAST RIGGS DENTAL LLC
Active
Organization
EAST RIGGS DENTAL LLC
Active
Other names
Canyon State Dental
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
2925 E RIGGS RD STE 2-3, CHANDLER, AZ 85249-3600
(480) 581-6633
Mailing address
2925 E RIGGS RD STE 2-3, CHANDLER, AZ 85249-3600
(480) 581-6633
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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