Individual
LEVI HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
881 N TYLER RD, WICHITA, KS 67212-3200
(316) 722-6717
Mailing address
881 N TYLER RD, WICHITA, KS 67212-3200
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
61061
KS
Other
Enumeration date
09/22/2015
Last updated
09/22/2015
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