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General NPI Number Information
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NPI Number | 1083864615
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Entity Type | Individual
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Provider Name | RICHARD ROGER HAN DDS
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Gender | Male
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Dates
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Enumeration Date | 09/18/2008
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Last Update Date | 09/15/2015
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Provider Practice Location Address
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Address Line | 11155 INTERNATIONAL DR
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-6096
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Country | US
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Telephone | 360-951-2452
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Fax |
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Provider Business Mailing Address
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Address Line | 9609 PASTURE ROSE WAY
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City | ELK GROVE
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State | CA
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Zip | 95624-6071
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Country | US
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Telephone | 360-951-2452
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 64370
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE60058989
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License Number State | WA
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