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Individual

DR. NILES M HANSEN III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2010 WEST 86TH STREET, SUITE 110, INDIANAPOLIS, IN 46260
(317) 872-4637
(317) 872-0557
Mailing address
2010 WEST 86TH STREET, SUITE 110, INDIANAPOLIS, IN 46260
(317) 872-4637
(317) 872-0557

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12006831
IN

Other

Enumeration date
05/29/2007
Last updated
07/08/2007
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