Organization
MICHAEL L HAMANN DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LARRY HAMANN DDS (PRESIDENT)
(218) 346-4775
Entity
Organization
Contact information
Practice address
200 1ST AVE S, PERHAM, MN 56573-1495
(218) 346-4775
(218) 346-5775
Mailing address
200 1ST AVE S, PERHAM, MN 56573-1495
(218) 346-4775
(218) 346-5775
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D7808
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61165HA
BC BS
—
01
—
989096
DENTAL SERVICE CORP
—
Enumeration date
05/07/2007
Last updated
08/22/2020
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