Provider Demographics
NPI:1457145245
Name:NEVADA DENTAL PROFESSIONAL, QUIRT, KRUYER, P.C.
Entity type:Organization
Organization Name:NEVADA DENTAL PROFESSIONAL, QUIRT, KRUYER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:HILLARY
Authorized Official - Middle Name:
Authorized Official - Last Name:THULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-540-8946
Mailing Address - Street 1:7919 TIERRA DEL SOL PKWY UNIT 141
Mailing Address - Street 2:
Mailing Address - City:SPANISH SPRINGS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-7505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7919 TIERRA DEL SOL PKWY UNIT 141
Practice Address - Street 2:
Practice Address - City:SPANISH SPRINGS
Practice Address - State:NV
Practice Address - Zip Code:89436-7505
Practice Address - Country:US
Practice Address - Phone:775-360-4265
Practice Address - Fax:775-360-4254
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEVADA DENTAL PROFESSIONAL, QUIRT, KRUYER, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty