Individual
MISS CALLIE JO HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, MDT
Contact information
Practice address
309 HOLLY LN, MANKATO, MN 56001-5422
(507) 388-2120
Mailing address
3502 HOEGER LN, ALBERT LEA, MN 56007-4220
(507) 383-3549
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
H11186
MN
125J00000X
Dental Therapist
Primary
DT151
MN
Other
Enumeration date
06/07/2022
Last updated
06/28/2022
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