Individual
MR. GREGORY BORG HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5270 W 84 ST, BLOOMINGTON, MN 55437
(952) 835-0666
(952) 835-1391
Mailing address
5270 W 84 ST, BLOOMINGTON, MN 55437
(952) 835-0666
(952) 835-1391
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1661240
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
303586
MEDICAL ASSITANCE
MN
Enumeration date
03/07/2006
Last updated
03/09/2016
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