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Individual

DOUGLAS A HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
4507 CHADWICK RD, CEDER FALLS, IA 50613
(319) 266-1433
(319) 266-3749
Mailing address
4507 CHADWICK RD, CEDER FALLS, IA 50613
(319) 266-1433
(319) 266-3749

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08107
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2236588
IA
Enumeration date
11/22/2006
Last updated
07/08/2007
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