# GLENN E. HURST DDS A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HURST FAMILY DENTAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043413354
- **Authorized official:** DR. GLENN E HURST DDS (PRESIDENT)
- **Authorized official phone:** (702) 897-1120

## Contact information

- **Practice address:** 7325 S PECOS RD, SUITE 101, LAS VEGAS, NV 89120
- **Practice address phone:** (702) 897-1120
- **Practice address fax:** (702) 897-4624
- **Mailing address:** 7325 S PECOS RD, SUITE 101, LAS VEGAS, NV 89120
- **Mailing address phone:** (702) 897-1120
- **Mailing address fax:** (702) 897-4624

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/06/2007
- **Last updated:** 07/27/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 535809 | UNITED CONCORDIA | NV |