Organization
PROVIDENCE DENTAL DHILLON PLLC
Active
Other names
Edge Dental & Orthodontics, Inspirada Dental & Orthodontics, Red Rock Kids Dental, Hello Kids Dental, Buffalo 215 Dental & Orthodontics, West Henderson Dental, Canyon Family Dentistry, Western Henderson Dental & Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY LORICK (CREDENTIALING SPECIALIST)
(704) 806-3632
Entity
Organization
Contact information
Practice address
7181 N HUALAPAI WAY, SUITE 105, LAS VEGAS, NV 89166-1115
(702) 349-2420
Mailing address
PO BOX 35145 LB 413169, SEATTLE, WA 98124
(919) 948-6787
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
S6-81
NV
Other
Enumeration date
01/14/2016
Last updated
01/03/2023
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