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NPI Code Detail

MEDICARE: AMANDA HANNA D.D.S.

MEDICARE:   AMANDA  HANNA  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
1122300000XDentist64093CA

General Provider Information

NPI Number : 1982096244
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA HANNA D.D.S.
Provider Business Mailing Address
First Line : 30057 VIA VICTORIA
Second Line :
City : RANCHO PALOS VERDES
State : CA
Zip : 90275-4435
Country : US
Telephone Number : 310-780-0106
Fax Number :
Provider Business Practice Location Address
First Line : 6616 CHERRY AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90805-1715
Country : US
Telephone Number : 310-780-0106
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2015
Last Update Date : 02/24/2015

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Directions to “ AMANDA HANNA D.D.S.” Practice Location

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