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Organization
PRESTON G. HANSEN, DDS, PLLC
Active
Organization
PRESTON G. HANSEN, DDS, PLLC
Active
Other names
Identity Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRESTON HANSEN DDS (OWNER)
(801) 251-7167
Entity
Organization
Contact information
Practice address
7138 S HIGHLAND DR STE 211, SALT LAKE CITY, UT 84121-3787
(801) 251-7167
(801) 880-4559
Mailing address
7138 S HIGHLAND DR STE 211, SALT LAKE CITY, UT 84121-3787
(801) 251-7167
(801) 880-4559
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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