Organization
RUSSELL K. HANES DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL K HANES DDS (PRESIDENT)
(520) 458-2415
Entity
Organization
Contact information
Practice address
1900 PASEO SAN LUIS, SIERRA VISTA, AZ 85635-4614
(520) 458-2415
Mailing address
1900 PASEO SAN LUIS, SIERRA VISTA, AZ 85635-4614
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3507
AZ
Other
Enumeration date
05/09/2007
Last updated
08/22/2020
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