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General NPI Number Information
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NPI Number | 1346732914
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER S. HANSEN, D.M.D., PLLC
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Dates
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Enumeration Date | 05/30/2018
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Last Update Date | 05/30/2018
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Provider Practice Location Address
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Address Line | 701 S COLLEGE AVE
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City | SALEM
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State | VA
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Zip | 24153-5167
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Country | US
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Telephone | 540-389-0491
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Fax |
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Provider Business Mailing Address
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Address Line | 1109 DICKORY AVE APT 230
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City | RIVER RIDGE
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State | LA
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Zip | 70123-2585
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Country | US
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Telephone | 425-299-1485
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER S HANSEN
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Credential | DMD
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Telephone | 425-299-1485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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