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Individual

DR. ROBERT WAYNE HANSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
4150 JEFFERSON ST, NAPA, CA 94558-1853
(707) 254-7249
Mailing address
4150 JEFFERSON ST, NAPA, CA 94558-1853
(707) 254-7249

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
21581
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21581
STATE LICENSE NUMBER
CA
Enumeration date
03/13/2007
Last updated
07/08/2007
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