Individual
DR. JOHN TIMOTHY HANSFORD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2171 JERICHO TPKE, COMMACK, NY 11725-2937
(631) 486-6364
Mailing address
102 NORMAN AVE, BROOKLYN, NY 11222-2934
(929) 324-1140
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
056107
NY
1223P0221X
Pediatric Dentistry
Primary
056107
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131740114
—
NY
Enumeration date
07/01/2011
Last updated
05/17/2016
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