Individual
PRESTON HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7138 S HIGHLAND DR, SUITE #211, SALT LAKE CITY, UT 84121-3757
(801) 251-7167
(801) 880-4559
Mailing address
7138 S HIGHLAND DR, SUITE #211, SALT LAKE CITY, UT 84121-3757
(801) 251-7167
(801) 880-4559
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
60916
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
30862
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9924
UT
Other
Enumeration date
05/03/2011
Last updated
09/18/2015
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