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NPI Code Detail

MEDICARE: RYANNE HAZEN DDS

MEDICARE:   RYANNE  HAZEN  DDS
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
11223G0001XGeneral Practice DentistryDN17674FL

General Provider Information

NPI Number : 1467463935
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYANNE HAZEN DDS
Provider Business Mailing Address
First Line : 3027 ROLLING HILLS LN
Second Line :
City : APOPKA
State : FL
Zip : 32712-6451
Country : US
Telephone Number : 407-889-8418
Fax Number :
Provider Business Practice Location Address
First Line : 19001 US HIGHWAY 441
Second Line :
City : MOUNT DORA
State : FL
Zip : 32757-6708
Country : US
Telephone Number : 352-383-9406
Fax Number : 352-383-9539
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 09/28/2010

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Directions to “ RYANNE HAZEN DDS” Practice Location

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