Healthcare Provider Details

I. General information

NPI: 1750368015
Provider Name (Legal Business Name): WILLIAM B. HANN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BAVARIA DENTAL ACTIVITY CREDENTIALS OFFICE UNIT 26610
APO AE
09244
US

IV. Provider business mailing address

BAVARIA DENTAL ACTIVITY CREDENTIALS OFFICE UNIT 26610
APO AE
09244
US

V. Phone/Fax

Practice location:
  • Phone: 011499318897714
  • Fax: 011499318897718
Mailing address:
  • Phone: 011499318897714
  • Fax: 011499318897718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS022900L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: