Provider Demographics
NPI:1053420778
Name:NORTH HILLS DENTAL ARTS SC
Entity type:Organization
Organization Name:NORTH HILLS DENTAL ARTS SC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NOELLE
Authorized Official - Middle Name:NICOLET
Authorized Official - Last Name:HANO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:262-255-4343
Mailing Address - Street 1:N80 W14832 APPLETON AVENUE
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051
Mailing Address - Country:US
Mailing Address - Phone:262-255-4343
Mailing Address - Fax:262-255-1968
Practice Address - Street 1:N80 W14832 APPLETON AVENUE
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051
Practice Address - Country:US
Practice Address - Phone:262-255-4343
Practice Address - Fax:262-255-1968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4433122300000X
WI4187122300000X
WI4001829122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty