Healthcare Provider Details

I. General information

NPI: 1851467195
Provider Name (Legal Business Name): GEORGE A HANKERSON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7629 EGAN DR
SAVAGE MN
55378-2208
US

IV. Provider business mailing address

15974 HYLAND POINTE CT
APPLE VALLEY MN
55124-7063
US

V. Phone/Fax

Practice location:
  • Phone: 952-440-5100
  • Fax: 952-440-5140
Mailing address:
  • Phone: 952-440-5100
  • Fax: 952-440-5140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number7309
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: