Individual
DR. JONATHAN MICHAEL HANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7632 S CAMPUS VIEW DR STE 150, WEST JORDAN, UT 84084-5545
(801) 282-5439
Mailing address
W6664 CASBERG COULEE RD, HOLMEN, WI 54636-9038
(361) 717-7008
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DEN-10197
CO
1223P0221X
Pediatric Dentistry
1001174
WI
1223P0221X
Pediatric Dentistry
Primary
9423399
UT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
1001174
WI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
S108
MN
Other
Enumeration date
06/17/2010
Last updated
12/01/2020
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