Organization
BLACK CANYON DENTAL, P.C.
Active
Other names
Black Canyon Dental
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRE CARDOSO DMD (CEO)
(801) 471-3690
Entity
Organization
Contact information
Practice address
1544 OXBOW DR STE 230, MONTROSE, CO 81401-5189
(801) 471-3690
Mailing address
3815 AVENUE F, BILLINGS, MT 59102-7546
(801) 471-3690
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/16/2022
Last updated
06/16/2022
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