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1306277546
CANYON RIVER DENTAL
PROVO, UT
NPI
1306277546
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Entity Type
Organization
Authorized Contact
MARK C LOMENICK
CFO
801-221-5859
Organization Subpart ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
Enumeration Date
2013-12-12
Last Update Date
2013-12-12
Business Address
CANYON RIVER DENTAL
3707 N CANYON RD SUITE 7D
PROVO, UT 84604-4592
Phone number: 801-221-5859
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Mailing Address
CANYON RIVER DENTAL
3707 N CANYON RD SUITE 7D
PROVO, UT 84604-4592
Phone number: 801-221-5859
Copy
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