# NORTHSIDE DENTAL RYAN DURNER, DDS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northside Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952918443
- **Authorized official:** DR. RYAN MATHEW DURNER DDS (OWNER)
- **Authorized official phone:** (614) 204-6818

## Contact information

- **Practice address:** 4254 HAMILTON AVE, CINCINNATI, OH 45223-2048
- **Practice address phone:** (614) 204-6818
- **Mailing address:** 4254 HAMILTON AVE, CINCINNATI, OH 45223-2048
- **Mailing address phone:** (513) 541-5655

## Taxonomy

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

## Other

- **Enumeration date:** 09/28/2020
- **Last updated:** 05/07/2021