| NPI | 1942604533 |
|---|---|
| Doing Business As | CANYON DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | RYAN HASTIIN WILSON President/Owner Dentist 505-278-7007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM DD3162) |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2014-10-10 |