Provider Demographics
NPI:1063567485
Name:HANSON, NORMAN J (DDS)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:J
Last Name:HANSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3844 PASEO GRANDE
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556-1535
Mailing Address - Country:US
Mailing Address - Phone:925-376-1948
Mailing Address - Fax:
Practice Address - Street 1:3844 PASEO GRANDE
Practice Address - Street 2:
Practice Address - City:MORAGA
Practice Address - State:CA
Practice Address - Zip Code:94556-1535
Practice Address - Country:US
Practice Address - Phone:925-376-1948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20756122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist