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Organization
HANAWALT DENTAL CORPORATION
Active
Organization
HANAWALT DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER M HANAWALT D.D.S (OWNER)
(909) 593-4581
Entity
Organization
Contact information
Practice address
2450 D ST, LA VERNE, CA 91750-4416
(909) 593-4581
Mailing address
2450 D ST, LA VERNE, CA 91750-4416
(909) 593-4581
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
124Q00000X
Dental Hygienist
—
—
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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