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General NPI Number Information
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NPI Number | 1003993742
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Entity Type | Organization
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Legal Business Name | HANSEN&HANSEN DDS LDT
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7212 EDGEBROOK LN
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City | HANOVER PARK
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State | IL
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Zip | 60133-3751
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Country | US
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Telephone | 630-837-3700
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Fax | 630-837-3849
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Provider Business Mailing Address
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Address Line | 7212 EDGEBROOK LN
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City | HANOVER PARK
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State | IL
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Zip | 60133-3751
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Country | US
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Telephone | 630-837-3700
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Fax | 630-837-3849
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | MRS. KATHY M HANSEN
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Credential | DDS
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Telephone | 630-837-3700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | IL
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