Organization
CHRIS J. HANSEN, DDS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERI ERTMAN (PRACTICE ADMINISTRATOR)
(920) 684-0123
Entity
Organization
Contact information
Practice address
1415 NORTH 8TH STREET, MANITOWOC, WI 54220-2051
(920) 684-0123
(920) 682-7374
Mailing address
1415 NORTH 8TH STREET, MANITOWOC, WI 54220-2051
(920) 684-0123
(920) 682-7374
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38394200
—
WI
Enumeration date
08/30/2006
Last updated
08/22/2020
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