Individual
MR. GEORGE HANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
204B NEEL AVENUE, SOCORRO, NM 87801
(575) 993-5032
(505) 226-9697
Mailing address
204B NEEL AVENUE, SOCORRO, NM 87801
(575) 993-5032
(505) 226-9697
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401411035
VA
122300000X
Dentist
Primary
DD4651
NM
122300000X
Dentist
DS036503
PA
332B00000X
Durable Medical Equipment & Medical Supplies
DD4651
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89223829
—
NM
Enumeration date
12/13/2006
Last updated
12/22/2023
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