Organization
GODDARD ORTHODONTICS PA
Active
Organization
GODDARD ORTHODONTICS PA
Active
Other names
Hansen Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEVI HANSEN DMD, MS (DOCTOR)
(316) 722-6717
Entity
Organization
Contact information
Practice address
19931 W KELLOGG DR, GODDARD, KS 67052-8863
(316) 722-6717
Mailing address
308 N HARRISON AVE, SEDGWICK, KS 67135-9477
(316) 652-5321
(316) 722-1371
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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