Healthcare Provider Details

I. General information

NPI: 1568543619
Provider Name (Legal Business Name): FRANCIS SIMONS HANE JR. DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 JONATHAN LUCAS
CHARLESTON SC
29425
US

IV. Provider business mailing address

9 ANDERSON AVE APT C
CHARLESTON SC
29412-3772
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-2094
  • Fax:
Mailing address:
  • Phone: 843-729-5409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number03964
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: