Organization
TERRY M. HANSEN, D.D.S., P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY M HANSEN D.D.S. (PRESIDENT)
(360) 331-5211
Entity
Organization
Contact information
Practice address
1685 E MAIN STREET, FREELAND, WA 98249
(360) 331-5211
(888) 760-8782
Mailing address
PO BOX 537, FREELAND, WA 98249-0537
(360) 331-5211
(888) 760-8782
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4716
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013929785
NPI TYPE 1
WA
Enumeration date
11/18/2008
Last updated
11/18/2008
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