Individual
BLAKE HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
18 BREWER AVE, ANNAPOLIS, MD 21401-3307
(308) 760-6376
Mailing address
18 BREWER AVE, ANNAPOLIS, MD 21401-3307
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17622
MD
Other
Enumeration date
07/17/2022
Last updated
07/17/2022
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