Provider Demographics
NPI:1275654808
Name:CVD CARE LLC
Entity Type:Organization
Organization Name:CVD CARE LLC
Other - Org Name:CANYON VISTA DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:BIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-982-0782
Mailing Address - Street 1:110 S IDAHO RD STE 260
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85119-2379
Mailing Address - Country:US
Mailing Address - Phone:480-982-0782
Mailing Address - Fax:
Practice Address - Street 1:110 S IDAHO RD STE 260
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85119-2379
Practice Address - Country:US
Practice Address - Phone:480-982-0782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD25611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty