Organization
HANNE DENTAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON HANNE DMD (OWNER)
(618) 972-8655
Entity
Organization
Contact information
Practice address
6655 EDWARDSVILLE CROSSING DR STE D, EDWARDSVILLE, IL 62025-2708
(618) 972-8655
(618) 656-9701
Mailing address
6655 EDWARDSVILLE CROSSING DR STE D, EDWARDSVILLE, IL 62025-2708
(618) 972-8655
(618) 656-9701
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.024344
IL
1223G0001X
General Practice Dentistry
015867
MO
332BC3200X
Customized Equipment (DME)
019.024344
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403393918
—
MO
Enumeration date
08/01/2017
Last updated
07/21/2022
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