Organization
BLAINE R HANSEN, DMD, MS
Active
Other names
Hansen Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY BAKER (INSURANCE COORDINATOR)
(702) 568-1600
Entity
Organization
Contact information
Practice address
3600 N BUFFALO DR STE 110, LAS VEGAS, NV 89129-7462
(702) 568-1600
(702) 568-1983
Mailing address
3600 N BUFFALO DR STE 110, LAS VEGAS, NV 89129-7462
(702) 568-1600
(702) 568-1983
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100556539
—
NV
Enumeration date
03/08/2022
Last updated
03/08/2022
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