Organization · Type 2 NPI

Coronado Canyon Dentistree

Dental Clinic/Center · Henderson, NV

NPI number 1043888936 Active

Practice location

660 S Green Valley Pkwy Ste 110
Henderson, NV 89052-0431

Specialties and licenses

Taxonomy	Code	License
Oral and Maxillofacial Surgery (Dentist)	1223S0112X	None listed
Dental Clinic/Center Primary	261QD0000X	None listed

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NPI record

NPI: 1043888936
Entity type: Organization (Type 2)
Issued: Jun 16, 2021
Last updated: Jun 6, 2023
Status: Active

Other names

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Eleazar Viray Santiago Gen PTR · doing business as
Eleazar Viray Santiago Gen PTR · other name

Authorized official

Eleazar Santiago
Doctor
(702) 610-8734

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About NPI 1043888936

Coronado Canyon Dentistree's National Provider Identifier is 1043888936, issued on Jun 16, 2021. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Henderson, NV. The record was last updated on Jun 6, 2023.