| NPI | 1447630116 |
|---|---|
| Doing Business As | CANYON ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | THOMAS HENRY Owner/Dentist 253-256-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: WA 10731) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA 5432) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2015-06-08 |