Shane R Hanson DMD

NPI 1710907787 - Dentist - 1223E0200X

NPI Details
NPI 1710907787
Gender Male
Enumeration Date 07/20/2006
Last Updated 08/26/2009
Entity Type Individual
Active Over 10 years ago
Practice Location
2999 W 10TH ST
PANAMA CITY FL, 32401-1444, US
Phone (850) 215-3339
Fax (888) 788-5217
Business Location
2999 W 10TH ST
PANAMA CITY FL, 32401-1444, US
Phone (850) 215-3339
Fax (888) 788-5217
Toxanomy
Taxonomy Code 1223E0200X
License State Illinois
License Number 19025779
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According to our database, Shane R Hanson DMD NPI is 1710907787, taxonomy code is 1223E0200X and license number is 19025779, license state is located at Illinois. Shane R Hanson DMD physically located at 2999 W 10th St, Panama City FL, 32401-1444. NPI Number Shane R Hanson DMD has the Individual type.

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1710907787 NPI number is provided on an as is basis without warranty of any kind. 1710907787 is maintained by the National Plan & Provider Enumeration System. The contents of Shane R Hanson DMD are for informational purposes only.