institution
Bryce D Hanson, Dmd Pa
Dental Clinic/Center in Shelley, Idaho
NPI 1851798045

Bryce D Hanson, Dmd Pa is a Dental Clinic/Center based in Shelley, ID and is specialized in Dental. Bryce D Hanson, Dmd Pa practices in Shelley, ID. The NPI Number for Bryce D Hanson, Dmd Pa is 1851798045 and holds a License No. D-3275 (Idaho).

The current practice location address for Bryce D Hanson, Dmd Pa is 371 W Fir St, Shelley, ID and can be reached out via phone at 208-357-7611 and via fax at 208-357-1805.

Location: 371 W Fir St, Shelley, ID, 83274-0525
institution
Provider Profile Details
NPI Number
1851798045
Provider Name
Bryce D Hanson, Dmd Pa
Credential
Provider Entity Type
Organization
Address
371 W Fir St, Shelley, ID, 83274-0525
Phone Number
208-357-7611
Fax Number
208-357-1805
Provider Enumeration Date
12/03/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0025-57200 05 ID
119-477-4109 05 ID
8050-31700 05 ID
institution
Provider Business Practice Location Address Details
Address
371 W Fir St
City
State
Zip
83274-1456
Phone Number
208-357-7611
Fax Number
208-357-1805
person
Provider Business Mailing Address Details
Address
371 W Fir St
City
State
Zip
83274-1456
Phone Number
208-357-7611
Fax Number
208-357-1805
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
License No.
D-3275 (Idaho)
Definition
Definition to come...
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