Organization
BLACK CANYON CITY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELDON W JENKINS (OWNER)
(623) 374-0855
Entity
Organization
Contact information
Practice address
34501 S OLD BLACK CANYON CITY HIGHWAY, SUITE 5, BLACK CANYON CITY, AZ 85324
(623) 374-0855
(623) 374-0854
Mailing address
PO BOX #7, BLACK CANYON CITY, AZ 85324
(623) 374-0855
(623) 374-0854
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
05797
AZ
Other
Enumeration date
05/24/2007
Last updated
08/22/2020
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