Individual
CARL ARTHUR HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
215 NORTH COURT ST, FAYETTEVILLE, WV 25840
(304) 574-1363
(304) 574-1363
Mailing address
PO BOX 508, 215 N COURT, FAYETTEVILLE, WV 25840
(304) 574-1363
(304) 574-1363
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2364
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0135245000
—
WV
Enumeration date
11/16/2006
Last updated
07/08/2007
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