Individual
DR. MICHAEL A HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
428 W GRAND AVE, PORT WASHINGTON, WI 53074-2142
(262) 284-5231
Mailing address
428 W GRAND AVE, PORT WASHINGTON, WI 53074-2142
(262) 284-5231
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5750-015
WI
Other
Enumeration date
03/10/2008
Last updated
03/10/2008
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