Organization
EAST RIGGS DENTAL LLC
Active
Other names
Canyon State Dental
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
2925 E RIGGS RD STE 2-3, CHANDLER, AZ 85249-3600
(480) 581-6633
Mailing address
2925 E RIGGS RD STE 2-3, CHANDLER, AZ 85249-3600
(480) 581-6633
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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