Individual
DR. JAN HANVEY-FAIRCHILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1310 S RANGE AVE, DENHAM SPRINGS, LA 70726-4810
(225) 664-7771
(225) 667-3285
Mailing address
1310 S RANGE AVE, DENHAM SPRINGS, LA 70726-4810
(225) 664-7771
(225) 667-3285
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3830
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1838306
—
LA
Enumeration date
04/02/2008
Last updated
04/02/2008
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