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DR. BRYCE D HANSON D.M.D

>> Dentist >> Dental Providers

Registrant NPI Number: 1629027099

Individual Registrant:
DR. BRYCE D HANSON D.M.D
Gender: M

Location and contact information for practice:
371 W FIR ST  SHELLEY, ID 83274-1456 US
Tel: 208-357-7611  Fax: 208-357-1805

Contact information for business:
PO BOX 525 371 W.FIR SHELLEY, ID 83274-0525 US
Tel: 208-357-7611  Fax: 208-357-1805

Registration Information:
NPI: 1629027099
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
IDD-3275

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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