DR. Larissa W Hanson, D.M.D.

NPI #1013320142 in Port Orange, Florida

Provider Information

NPI Number: 1013320142
Entity Type: Individual
Name: DR. Larissa W Hanson, D.M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: D.M.D.
Enumeration Date: Jun 5, 2014
Last Updated: Jul 21, 2014

Practice Location

Address: 3777 S RIDGEWOOD AVE
City: Port Orange
State: Florida
ZIP Code: 32129-3528
Phone: (386) 760-1200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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