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General NPI Number Information
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NPI Number | 1457542284
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Entity Type | Individual
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Provider Name | ERIC D HANSON DDS
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Gender | Male
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 02/24/2010
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Provider Practice Location Address
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Address Line | 2820 NW 32ND ST
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City | NEWCASTLE
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State | OK
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Zip | 73065-6576
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Country | US
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Telephone | 405-392-4883
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Fax | 405-392-4889
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Provider Business Mailing Address
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Address Line | 2820 NW 32ND ST
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City | NEWCASTLE
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State | OK
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Zip | 73065-6576
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Country | US
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Telephone | 405-392-4883
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Fax | 405-392-4889
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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 | 5497384-9922
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6093
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License Number State | OK
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