Individual
EUGENE HAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S, M.S
Contact information
Practice address
809 SW ALSBURY BLVD # 100, BURLESON, TX 76028-9200
(817) 426-1406
Mailing address
1001 W ROSEDALE ST APT 1555, FORT WORTH, TX 76104-4930
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
61632
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
37165
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
61632
CA
Other
Enumeration date
08/13/2012
Last updated
12/07/2021
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