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General NPI Number Information
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NPI Number | 1124339049
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Entity Type | Individual
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Provider Name | MICHAEL HANSEN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2010
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 458 MANOR HARRISON CITY RD
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City | HARRISON CITY
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State | PA
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Zip | 15636-1102
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Country | US
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Telephone | 412-848-8232
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Fax |
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Provider Business Mailing Address
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Address Line | 109 DELLVIEW CT
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City | GREENSBURG
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State | PA
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Zip | 15601-3775
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Country | US
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Telephone | 412-848-8232
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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 | DS038403
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License Number State | PA
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