# COPPERMINE MADERA CANYON LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coppermine Dental Studio
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679326938
- **Authorized official:** JENNY GARCIA ROCHA (SR TEAM LEAD)
- **Authorized official phone:** (972) 869-3789

## Contact information

- **Practice address:** 685 S PECAN TREE LN, GREEN VALLEY, AZ 85614-5114
- **Practice address phone:** (520) 625-1600
- **Practice address fax:** (520) 838-0865
- **Mailing address:** 685 S PECAN TREE LN, GREEN VALLEY, AZ 85614-5114
- **Mailing address phone:** (520) 625-1600
- **Mailing address fax:** (520) 838-0865

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 04/08/2024
- **Last updated:** 04/08/2024