| R.t.hansen,jr., D.m.d., Inc. | |
|
1321 N Harbor Blvd Suite 104 Fullerton CA 92835-4124 | |
| (714) 870-0310 | |
| (714) 870-0153 |
| Full Name | R.t.hansen,jr., D.m.d., Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1321 N Harbor Blvd, Fullerton, California |
| Authorized Official Name and Position | Richard Thomas Hansen (OWNER) |
| Authorized Official Contact | 7148700310 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| R.t.hansen,jr., D.m.d., Inc. 1321 N Harbor Blvd Suite 104 Fullerton CA 92835-4124 Ph: (714) 870-0310 | R.t.hansen,jr., D.m.d., Inc. 1321 N Harbor Blvd Suite 104 Fullerton CA 92835-4124 Ph: (714) 870-0310 |
| NPI Number | 1912449364 |
|---|---|
| Provider Enumeration Date | 11/15/2016 |
| Last Update Date | 11/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912449364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 26070 (California) | Primary |
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