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NPI Code Detail

MEDICARE: DR. LORRAINE D. HANNA D.D.S.

MEDICARE: DR. LORRAINE D. HANNA D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry15918MI

General Provider Information

NPI Number : 1598760530
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LORRAINE D. HANNA D.D.S.
Provider Business Mailing Address
First Line : 4017 W MAIN ST
Second Line : STE 300
City : KALAMAZOO
State : MI
Zip : 49006-3731
Country : US
Telephone Number : 269-349-3203
Fax Number : 269-349-5721
Provider Business Practice Location Address
First Line : 4017 W MAIN ST
Second Line : STE 300
City : KALAMAZOO
State : MI
Zip : 49006-3731
Country : US
Telephone Number : 269-349-3203
Fax Number : 269-349-5721
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 07/08/2007

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