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General NPI Number Information
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NPI Number | 1043413354
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Entity Type | Organization
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Legal Business Name | GLENN E. HURST DDS A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 07/27/2016
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Provider Practice Location Address
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Address Line | 7325 S PECOS RD SUITE 101
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City | LAS VEGAS
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State | NV
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Zip | 89120
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Country | US
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Telephone | 702-897-1120
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Fax | 702-897-4624
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Provider Business Mailing Address
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Address Line | 7325 S PECOS RD SUITE 101
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City | LAS VEGAS
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State | NV
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Zip | 89120
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Country | US
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Telephone | 702-897-1120
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Fax | 702-897-4624
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GLENN E HURST
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Credential | DDS
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Telephone | 702-897-1120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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