J Clayton Hansen DDS Pllc

NPI #1558458281 in Moscow, Idaho

Provider Information

NPI Number: 1558458281
Entity Type: Organization
Organization Name: J Clayton Hansen DDS Pllc
Primary Specialty: Dentist
Enumeration Date: Oct 6, 2006
Last Updated: Apr 26, 2012

Practice Location

Address: 1526 S LEVICK ST
City: Moscow
State: Idaho
ZIP Code: 83843-2560
Phone: (208) 882-4923

Authorized Official

Name: JAY CLAYTON HANSEN, DDS
Title: DENTIST/OWNER
Phone: (208) 882-4923

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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