# TERRY M. HANSEN, D.D.S., P.L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235384330
- **Authorized official:** TERRY M HANSEN D.D.S. (PRESIDENT)
- **Authorized official phone:** (360) 331-5211

## Contact information

- **Practice address:** 1685 E MAIN STREET, FREELAND, WA 98249
- **Practice address phone:** (360) 331-5211
- **Practice address fax:** (888) 760-8782
- **Mailing address:** PO BOX 537, FREELAND, WA 98249-0537
- **Mailing address phone:** (360) 331-5211
- **Mailing address fax:** (888) 760-8782

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 4716 | WA | Yes |

## Other

- **Enumeration date:** 11/18/2008
- **Last updated:** 11/18/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1013929785 | NPI TYPE 1 | WA |