Provider Demographics
NPI:1770265407
Name:HILLSIDE DENTAL CARE, LLC
Entity type:Organization
Organization Name:HILLSIDE DENTAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:W
Authorized Official - Last Name:WOLF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-251-1734
Mailing Address - Street 1:7241 N THORNYDALE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2045
Mailing Address - Country:US
Mailing Address - Phone:520-744-0700
Mailing Address - Fax:877-581-5499
Practice Address - Street 1:7241 N THORNYDALE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2045
Practice Address - Country:US
Practice Address - Phone:520-744-0700
Practice Address - Fax:877-581-5499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty