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Individual
GENTRY MICHAEL HANSEN
Active
Individual
GENTRY MICHAEL HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
09513
IA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
11002
SD
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
32567
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
45169
IA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D1197
SD
Other
Enumeration date
05/01/2012
Last updated
03/07/2024
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