MEDICARE: DR. WILLIAM ROBERT HANSMANN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	20080	FL

General Provider Information

NPI Number	:	1134347222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM ROBERT HANSMANN D.D.S.

Provider Business Mailing Address
First Line	:	2686 SCOBEE DR
Second Line	:	SUITE 104
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-7211
Country	:	US
Telephone Number	:	770-977-1632
Fax Number	:	770-578-8140

Provider Business Practice Location Address
First Line	:	3823 ROSWELL RD
Second Line	:	SUITE 104
City	:	MARIETTA
State	:	GA
Zip	:	30062-6278
Country	:	US
Telephone Number	:	770-977-1632
Fax Number	:	770-578-8140

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	01/08/2016

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