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General NPI Number Information
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NPI Number | 1427531441
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Entity Type | Organization
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Legal Business Name | JOHN T. HANSFORD JR. DMD BOARD CERTIFIED PEDIATRIC DENTAL SPECIALIST P
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Dates
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Enumeration Date | 09/14/2018
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 102 NORMAN AVE
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City | BROOKLYN
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State | NY
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Zip | 11222-2934
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Country | US
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Telephone | 929-324-1140
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Fax | 929-529-6117
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Provider Business Mailing Address
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Address Line | 102 NORMAN AVE
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City | BROOKLYN
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State | NY
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Zip | 11222-2934
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Country | US
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Telephone | 929-324-1140
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Fax | 929-529-6117
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN T. HANSFORD JR.
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Credential | DMD
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Telephone | 929-324-1140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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