Organization
CANYON RIVER DENTAL
Active
Parent organization
EL AL CHINN EEM
Organization subpart
Yes
Provider details
NPI number
Legal business name
EL AL CHINN EEM
Authorized official
MARK C LOMENICK (CFO)
(801) 221-5859
Entity
Organization
Contact information
Practice address
3707 N CANYON RD, SUITE 7D, PROVO, UT 84604-4592
(801) 221-5859
(801) 221-7091
Mailing address
3707 N CANYON RD, SUITE 7D, PROVO, UT 84604-4592
(801) 221-5859
(801) 221-7091
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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