# SOUTH SIDE DENTAL CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134831324
- **Authorized official:** DR. RACHEL NGUYEN DMD (DENTIST)
- **Authorized official phone:** (717) 503-8052

## Contact information

- **Practice address:** 4808 DERRY ST, HARRISBURG, PA 17111-3440
- **Practice address phone:** (717) 564-9250
- **Mailing address:** 332 GOLDFINCH LN, HUMMELSTOWN, PA 17036-8859
- **Mailing address phone:** (717) 503-8052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/19/2022
- **Last updated:** 12/19/2022