| NPI | 1194021170 |
|---|---|
| Doing Business As | CANYON MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JAMES B MALLORY Owner Doctor 623-546-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2011-02-08 |