Individual
JUSTIN HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
279 E 5900 S STE 200, SALT LAKE CITY, UT 84107-5424
(801) 671-3786
Mailing address
7686 S 455 E, MIDVALE, UT 84047-2708
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8340879-9922
UT
Other
Enumeration date
04/13/2012
Last updated
01/31/2018
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