Organization
CANYON TRAILS FAMILY DENTAL- VERRADO LLC
Active
Other names
Canyon Trails Family Dental- Verrado
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY GARCIA-ROCHA (CREDENTIALING LEAD)
(972) 869-3789
Entity
Organization
Contact information
Practice address
20800 W MARKET ST STE 107, BUCKEYE, AZ 85396-8040
(623) 401-2959
Mailing address
20800 W MARKET ST STE 107, BUCKEYE, AZ 85396-8040
(623) 401-2959
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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