Organization
CANYON RIVER DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACI M FRANC (MANAGER)
(801) 221-5859
Entity
Organization
Contact information
Practice address
3707 N CANYON RD STE 7D, PROVO, UT 84604-4586
(801) 221-5859
(801) 221-7091
Mailing address
3707 N CANYON RD STE 7D, PROVO, UT 84604-4586
(801) 221-5859
(801) 221-7091
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
312434
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529578391004
—
UT
Enumeration date
03/30/2009
Last updated
03/30/2009
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