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Individual

DR. BRAD THOMAS HANEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DD

Contact information

Practice address
402 2ND ST., PAONIA, CO 81428-0308
(970) 527-4853
(970) 527-4855
Mailing address
P. O. BOX 308, 402 2ND ST., PAONIA, CO 81428-0308
(970) 527-4853
(970) 527-4855

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
104426
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
104426
LICENSE
CO
Enumeration date
07/31/2006
Last updated
07/08/2007
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