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Organization
CANYON SURGICAL SPECIALISTS LLC
Active
Organization
CANYON SURGICAL SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE FALK DMD (MEMBER)
(702) 660-5574
Entity
Organization
Contact information
Practice address
6200 N DURANGO DR STE 100, LAS VEGAS, NV 89149-3939
(702) 660-5574
Mailing address
6200 N DURANGO DR STE 100, LAS VEGAS, NV 89149-3939
(702) 660-5574
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
NULL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
207Y00000X
Otolaryngology Physician
—
NULL
207Y00000X
Otolaryngology Physician
—
—
Other
Enumeration date
03/17/2023
Last updated
03/17/2023
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