Organization
PRESTON G. HANSEN, DDS, PLLC
Active
Other names
Identity Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRESTON HANSEN DDS (OWNER)
(801) 251-7167
Entity
Organization
Contact information
Practice address
7138 S HIGHLAND DR STE 211, SALT LAKE CITY, UT 84121-3787
(801) 251-7167
(801) 880-4559
Mailing address
7138 S HIGHLAND DR STE 211, SALT LAKE CITY, UT 84121-3787
(801) 251-7167
(801) 880-4559
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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