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General NPI Number Information
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NPI Number | 1578239810
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Entity Type | Organization
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Legal Business Name | JOHN T. HANSFORD DMD P.C.
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 08/17/2021
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Provider Practice Location Address
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Address Line | 1091 PARK DR STE A
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City | WATKINSVILLE
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State | GA
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Zip | 30677-2014
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Country | US
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Telephone | 918-221-6860
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Fax |
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Provider Business Mailing Address
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Address Line | 1091 PARK DR STE A
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City | WATKINSVILLE
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State | GA
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Zip | 30677-2014
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Country | US
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Telephone |
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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. JOHN HANSFORD
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Credential |
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Telephone | 918-221-6860
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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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