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NPI Code Detail

MEDICARE: DR. GREG ALAN HANSON D.D.S.

MEDICARE:  DR. GREG ALAN HANSON  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
11223G0001XGeneral Practice DentistryM-514SD

General Provider Information

NPI Number : 1639254006
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREG ALAN HANSON D.D.S.
Provider Business Mailing Address
First Line : 801 MOUNT RUSHMORE RD
Second Line : SUITE 201
City : RAPID CITY
State : SD
Zip : 57701-3614
Country : US
Telephone Number : 605-341-1895
Fax Number : 605-348-7177
Provider Business Practice Location Address
First Line : 801 MOUNT RUSHMORE RD
Second Line : SUITE 201
City : RAPID CITY
State : SD
Zip : 57701-3614
Country : US
Telephone Number : 605-341-1895
Fax Number : 605-348-7177
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 07/08/2007

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Directions to “ DR. GREG ALAN HANSON D.D.S.” Practice Location

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