Organization
CANYON CREEK FAMILY DENTISTRY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AFSHIN AZMOODEH D.D.S. (PRESIDENT)
(972) 644-3800
Entity
Organization
Contact information
Practice address
2091 N COLLINS BLVD STE 100, RICHARDSON, TX 75080-2636
(972) 644-3800
(972) 644-3888
Mailing address
2091 N COLLINS BLVD STE 100, RICHARDSON, TX 75080-2636
(972) 644-3800
(972) 644-3888
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20074
TX
1223P0221X
Pediatric Dentistry
24260
TX
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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