Individual
DR. MARTY J HANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8385 N CORNERSTONE DR, HAYDEN, ID 83835-8684
(208) 772-5141
(208) 772-8322
Mailing address
8385 N CORNERSTONE DR, HAYDEN, ID 83835-8684
(208) 772-5141
(208) 772-8322
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1777
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
67934
BLUE CROSS OF IDAHO
ID
Enumeration date
08/13/2006
Last updated
07/08/2007
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