Organization
SEABREEZE ENDODONTICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANE ROBERT HANSON DMD (PRESIDENT)
(850) 424-7368
Entity
Organization
Contact information
Practice address
4579 E HIGHWAY 20 STE 220, NICEVILLE, FL 32578-9808
(850) 424-7368
Mailing address
4579 E HIGHWAY 20 STE 220, NICEVILLE, FL 32578-9808
(850) 424-7368
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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