Chris Hansen Dmd PA

NPI #1053632919 in Pocatello, Idaho

Provider Information

NPI Number: 1053632919
Entity Type: Organization
Organization Name: Chris Hansen Dmd PA
Primary Specialty: Dentist
Enumeration Date: Jun 15, 2010
Last Updated: Jun 15, 2010

Practice Location

Address: 333 W CEDAR ST
City: Pocatello
State: Idaho
ZIP Code: 83201-5045
Phone: (208) 233-5362

Authorized Official

Name: DR. CHRIS D HANSEN, DMD
Title: OWNER
Phone: (208) 233-5362

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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