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Individual

PETER MICHAEL HANSON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1503 RANDOLPH CT, MANITOWOC, WI 54220-8345
(920) 682-0321
(920) 682-3128
Mailing address
1503 RANDOLPH CT, MANITOWOC, WI 54220-8345
(920) 682-0321
(920) 682-3128

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1679G
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33545500
WI
Enumeration date
08/19/2005
Last updated
07/08/2007
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