Individual
DR. OTTO JULIUS HANSSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
21515 STATE ROUTE 410 E, SUITE A, BONNEY LAKE, WA 98391-4100
(253) 826-9000
(253) 826-0328
Mailing address
21515 STATE ROUTE 410 E, SUITE A, BONNEY LAKE, WA 98391-4100
(253) 826-9000
(253) 826-0328
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00005262
WA
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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