| NPI | 1407243579 |
|---|---|
| Doing Business As | CANYON RIDGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | MICHAEL ALLAN BLAMIRES President 801-710-3536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 361602-9922) |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2015-04-16 |