Individual
DR. MICHAEL HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
519 S SANTA FE AVE, EDMOND, OK 73003-6281
(405) 844-6100
(405) 844-6172
Mailing address
519 S SANTA FE AVE, EDMOND, OK 73003-6281
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5712
OK
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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