Organization
CANYON MODERN DENTISTRY, LLP
Active
Other names
Canyon Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES B MALLORY JR. DMD (OWNER DOCTOR)
(623) 546-8400
Entity
Organization
Contact information
Practice address
17081 W GREENWAY RD STE 121, SURPRISE, AZ 85388-9612
(623) 546-8400
(623) 214-5830
Mailing address
2860 MICHELLE DRIVE 2ND FLOOR, IRVINE, CA 92606
(714) 368-2077
(714) 368-2092
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/08/2011
Last updated
02/08/2011
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