Organization
CANYON TRAILS DENTAL CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK DELWYN WHEELER DMD (OWNER DENTIST)
(623) 882-0782
Entity
Organization
Contact information
Practice address
500 N ESTRELLA PKWY, SUITE B1, GOODYEAR, AZ 85338-4135
(623) 882-0782
Mailing address
500 N ESTRELLA PKWY, SUITE B1, GOODYEAR, AZ 85338-4135
(623) 882-0782
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5594
AZ
Other
Enumeration date
01/29/2007
Last updated
08/22/2020
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