Canyon Dental Inc.
Organization Active NPI General Practice Dentistry · Hacienda Heights, CA
NPI 1922599240 · NPPES record last updated May 22, 2018
Key facts
- NPI
- 1922599240
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Legal business name
- CANYON DENTAL INC.
- Practice address
- 2219 S Hacienda Blvd Ste 202
Hacienda Heights, CA 91745-4610 - Phone
- (626) 369-8617
- Fax
- (626) 369-0257
- NPI assigned
- May 22, 2018
- Organization subpart
- No
Authorized official
- Name
- Gabriel De la Vara
- Title
- Dentist
- Phone
- (626) 369-8617
Practitioners 1
-
Gabriel Delavara, D.D.S
National Provider Directory
Locations
2219 S Hacienda Blvd
Ste 202
Hacienda Heights, CA 91745
Phone (626) 369-8617
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | Yes |
Addresses
Primary practice location
2219 S Hacienda Blvd Ste 202
Hacienda Heights, CA 91745-4610
Mailing address
2219 S Hacienda Blvd Ste 202
Hacienda Heights, CA 91745-4610
Phone (626) 369-8617
Other names
- Canyon Dental
Other providers in Hacienda Heights, CA
- Daniel Calvera
- Ashanty Camacho-Gonzalez
- Cynthia Camacho
- Jesse Camarillo
- Isabel Campos
- Kevin Cardenas
- Maria Elena Valera Cardenas
- Yaraseth Cardenas
- Care Associates, Inc.
- Care Associates, Inc.
All providers in Hacienda Heights, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.