Hanneman Dustrude Dental LLC

NPI #1689018848 in Oshkosh, Wisconsin

Provider Information

NPI Number: 1689018848
Entity Type: Organization
Organization Name: Hanneman Dustrude Dental LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 18, 2013
Last Updated: Apr 18, 2013

Practice Location

Address: 1218 WITZEL AVE
City: Oshkosh
State: Wisconsin
ZIP Code: 54902-5659
Phone: (920) 233-6001

Authorized Official

Name: DR. MICHAEL LLOYD HANNEMAN, DDS
Title: OWNER
Phone: (920) 233-6001

Specialties & Taxonomy Codes

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

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