Organization
FRED M HANNAN SR, D.D.S., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED M HANNAN SR. D.D.S. (DENTIST)
(706) 793-3600
Entity
Organization
Contact information
Practice address
4108 WINDSOR SPRING RD, HEPHZIBAH, GA 30815-5910
(706) 793-3600
Mailing address
4108 WINDSOR SPRING RD, HEPHZIBAH, GA 30815-5910
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6539
GA
Other
Enumeration date
09/08/2008
Last updated
09/08/2008
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