MEDICARE: DR. DAEHYUN HAN

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
1	1223G0001X	General Practice Dentistry	6327	NV

General Provider Information

NPI Number	:	1942557897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAEHYUN HAN

Provider Business Mailing Address
First Line	:	10042 CANYON DUNES AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-8284
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6707 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-9240
Country	:	US
Telephone Number	:	702-438-0888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2012
Last Update Date	:	02/08/2013

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