Organization
SCOTT M HANNAMAN DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT MARTIN HANNAMAN DDS (OWNER)
(337) 474-4892
Entity
Organization
Contact information
Practice address
1540 COUNTRY CLUB RD, LAKE CHARLES, LA 70605-5324
(337) 474-4892
Mailing address
1540 COUNTRY CLUB RD, LAKE CHARLES, LA 70605-5324
(337) 474-4892
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6155
LA
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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