# HILLSIDE DENTAL LTD

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

## Provider details

- **NPI number:** 1962260034
- **Authorized official:** MR. RYAN WAGNER (CEO)
- **Authorized official phone:** (702) 895-7799

## Contact information

- **Practice address:** 6090 S. FORT APACHE, STE 120 HILLSIDE DENTAL, LAS VEGAS, NV 89148
- **Practice address phone:** (702) 895-7799
- **Practice address fax:** (702) 895-7192
- **Mailing address:** 6090 S. FORT APACHE, STE 120 HILLSIDE DENTAL, LAS VEGAS, NV 89148
- **Mailing address phone:** (702) 895-7799
- **Mailing address fax:** (702) 895-7192

## Taxonomy

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

## Other

- **Enumeration date:** 03/12/2024
- **Last updated:** 03/12/2024