# DR. BRYCE D HANSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1629027099
- **Gender:** Man
- **Credential:** D.M.D

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | D-3275 | ID | Yes |

## Other

- **Enumeration date:** 05/10/2006
- **Last updated:** 10/12/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 805031700 | — | ID |