Individual
DR. TIMOTHY S HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1615 14TH ST NW, ROCHESTER, MN 55901-0257
(507) 289-3921
(507) 288-2450
Mailing address
1615 14TH ST NW, ROCHESTER, MN 55901-0257
(507) 289-3921
(507) 288-2450
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12998
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D12998
MN DENTAL LICENSE #
MN
Enumeration date
07/07/2011
Last updated
07/07/2011
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