Individual
DOUGLAS HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1256 S STATE ST, OREM, UT 84097-8237
(801) 607-5024
Mailing address
13849 S PIONEER PEAK CIR, HERRIMAN, UT 84096-1904
(801) 201-8366
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9141917-8903
UT
Other
Enumeration date
09/11/2014
Last updated
09/22/2015
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