| Southridge Dental | |
|
1000 Wigwam Pkwy Ste 120 Henderson NV 89074-8164 | |
| (702) 777-4700 | |
| (702) 777-0700 |
| Full Name | Southridge Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1000 Wigwam Pkwy Ste 120, Henderson, Nevada |
| Authorized Official Name and Position | Byronn Gene Hahn (OWNER) |
| Authorized Official Contact | 7027774700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southridge Dental 1000 Wigwam Pkwy Ste 120 Henderson NV 89074-8164 Ph: (702) 777-4700 | Southridge Dental 1000 Wigwam Pkwy Ste 120 Henderson NV 89074-8164 Ph: (702) 777-4700 |
| NPI Number | 1821115338 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 08/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821115338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5105 (Nevada) | Primary |
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