Individual
DR. CHAD RAYMOND HANNEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2441 CORAL COURT #5, CORALVILLE, IA 52241
(319) 545-6251
(319) 545-7265
Mailing address
2441 CORAL COURT #5, CORALVILLE, IA 52241
(319) 545-6251
(319) 545-7265
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8001
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1219089
—
IA
01
—
1382746
CONCORDIA
IA
01
—
20737
BCBS
IA
Enumeration date
04/19/2007
Last updated
07/08/2007
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