Individual
DR. BRIAN T. HANSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2105 N. CITRUS LN, ASPC-PERRYVILLE, PHOENIX, AZ 85395
(702) 808-6530
Mailing address
2105 N. CITRUS LN, ASPC-PERRYVILLE, PHOENIX, AZ 85395
(702) 808-6530
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
D07603
AZ
Other
Enumeration date
12/26/2013
Last updated
12/26/2013
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