Individual
DR. FRED M HANNAN SR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4108 WINDSOR SPRING RD, SUITE B, HEPHZIBAH, GA 30815-5910
(706) 793-3600
(706) 793-8641
Mailing address
4108 WINDSOR SPRING RD, SUITE B, HEPHZIBAH, GA 30815-5910
(706) 793-3600
(706) 793-8641
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6539
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149313
UNITED CONCORDIA ID
GA
Enumeration date
01/22/2006
Last updated
07/09/2007
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