Individual
ANDREW HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1405 JUDSON RD, LONGVIEW, TX 75601-3918
(903) 212-7737
(903) 212-7745
Mailing address
1405 JUDSON RD, LONGVIEW, TX 75601-3918
(903) 212-7737
(903) 212-7745
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
0442000228
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
31753
TX
Other
Enumeration date
01/13/2015
Last updated
11/04/2020
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