Individual
DR. MICHAEL ALLEN HANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
204 N ADAMS ST, KNOB NOSTER, MO 65336
(660) 563-6030
(660) 563-4347
Mailing address
PO BOX 812, 510 E GAY ST STE G, WARRENSBURG, MO 64093
(660) 747-7950
(660) 563-4347
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
MO15311
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M015311
STATE LICENSE
MO
Enumeration date
09/06/2006
Last updated
07/08/2007
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