Individual
DR. GARY WAYNE HANSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6301 N OAK TRFY, SUITE 101, KANSAS CITY, MO 64118-4705
(816) 452-0300
(816) 452-3385
Mailing address
6301 N OAK TRFY, SUITE 101, KANSAS CITY, MO 64118-4705
(816) 452-0300
(816) 452-3385
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
014326
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11515081
BC/BS
MO
Enumeration date
08/30/2005
Last updated
07/08/2007
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