OrganizationActive
Canyon Road Dental PLLC
NPI 1700450905 · General Practice Dentistry · Provo, UT
Provider details
- NPI number
- 1700450905
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Faith Gaskins, Director of Credentialing(972) 869-3789
Specialties & taxonomies
Dental Providers
Practice location
3707 N Canyon Rd Ste 2a
Provo, UT 84604-4525
Phone: (801) 997-6728
Fax: (385) 374-1555
Approximate (ZIP-level) locationGet directions
Mailing address
3707 N Canyon Rd Ste 2a
Provo, UT 84604-4525
Other names (DBA / former)
- Doing business as
- Canyon Road Dental
Registry dates
- Enumerated
- 2021-05-13
- Last updated
- 2021-05-13
- Certified
- 2021-05-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.