NPI | 1932674108 |
---|---|
Doing Business As | CANYON STATE ORAL AND DENTAL IMPLANT SURGERY |
Entity Type | Organization |
Authorized Contact | ANDREW RAY Oral Surgeon 480-899-8893 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
Enumeration Date | 2018-10-03 |
Last Update Date | 2018-10-03 |