Organization
CANYON VISTA DENTISTRY AND ORTHODONTICS,LLP
Active
Other names
Canyon Vista Dentistry and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD R COCKRELL DMD (OWNER DOCTOR)
(626) 561-6767
Entity
Organization
Contact information
Practice address
25155 N 67TH AVE STE 142, PHOENIX, AZ 85083-1065
(626) 561-6767
(623) 561-1703
Mailing address
2860 MICHELLE FL 2, IRVINE, CA 92606-1008
(714) 368-2077
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/10/2010
Last updated
03/10/2010
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