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Organization
HANSEEN ORTHODONTICS
Active
Organization
HANSEEN ORTHODONTICS
Active
Parent organization
JACOB HANSEEN DMD INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JACOB HANSEEN DMD INC
Authorized official
DR. JACOB HANSEEN DMD (PRESIDENT)
(801) 918-3866
Entity
Organization
Contact information
Practice address
237 S GLENDORA AVE, GLENDORA, CA 91741-3451
(801) 918-3866
Mailing address
1119 ENGLEWILD DR, GLENDORA, CA 91741-2286
(801) 918-3866
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/13/2023
Last updated
06/13/2023
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