Individual
DR. DAVID M HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
#4 CEDAR STREET, SAN FELIPE, NM 87001
(505) 867-5025
Mailing address
189 CAMINO RAYO DEL SOL, CORRALES, NM 87048-6924
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1855
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
J5613
—
NM
Enumeration date
12/13/2006
Last updated
07/08/2007
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