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General NPI Number Information
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NPI Number | 1366636128
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Entity Type | Individual
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Provider Name | GEORGE JOSEPH HANNA DDS
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Gender | Male
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 350 S LAKE AVE STE 250
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City | PASADENA
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State | CA
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Zip | 91101-3532
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Country | US
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Telephone | 626-449-2239
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Fax |
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Provider Business Mailing Address
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Address Line | 4313 OAKWOOD AVE
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City | LA CANADA
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State | CA
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Zip | 91011-3412
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Country | US
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Telephone | 714-932-6024
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 56218
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License Number State | CA
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