Individual
DR. SCOTT EUGENE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5216 SHERIDAN ST STE 160, DAVENPORT, IA 52806-3972
(563) 386-7540
Mailing address
4820 LINDBERGH DR, BETTENDORF, IA 52722-2093
(563) 449-9743
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
07524
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0076299
—
IA
01
—
07524
STATE DENTAL LICENSE
IA
Enumeration date
10/02/2006
Last updated
07/09/2007
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