| NPI | 1255060109 |
|---|---|
| Doing Business As | CANYON CREEK FAMILY & IMPLANT DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | COURTNEY MONTEITH Credentialing Coordinator 217-540-8306 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2022-06-07 |