Individual
DR. JONATHAN HANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-2040
(414) 266-5677
Mailing address
9000 W WISCONSIN AVE # MS 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-6238
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1001933
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407313521
—
WI
Enumeration date
02/25/2019
Last updated
07/01/2019
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