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Individual

DR. VINCENT J HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1135 SOUTH CESAR E CHAVEZ DR., MILWAUKEE, WI 53204-2266
(414) 645-4540
Mailing address
1135 SOUTH CESAR E CHAVEZ DR.., MILWAUKEE, WI 53204-2266

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
12011501A
IN
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6972-15
WI

Other

Enumeration date
08/09/2012
Last updated
08/09/2012
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