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Organization

DOUGLAS W HANNEMAN DDS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOUGLAS WILLIAM HANNEMAN DDS (PRESIDENT)
(319) 472-5209
Entity
Organization

Contact information

Practice address
118 EAST 4TH STREET, VINTON, IA 52349-1757
(319) 472-5209
Mailing address
118 EAST 4TH STREET, VINTON, IA 52349-1757
(319) 472-5209

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6311
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0153247
IA
Enumeration date
12/20/2006
Last updated
08/22/2020
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