Organization
GREG A HANSON DDS PROF LLC
Active
Other names
Boulevard Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREG A. HANSON DDS (OWNER)
(605) 341-1895
Entity
Organization
Contact information
Practice address
801 MOUNT RUSHMORE RD, SUITE 201, RAPID CITY, SD 57701-3614
(605) 341-1895
(605) 348-7177
Mailing address
801 MOUNT RUSHMORE RD, SUITE 201, RAPID CITY, SD 57701-3614
(605) 341-1895
(605) 348-7177
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
M514
SD
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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