Provider Demographics
NPI:1134159759
Name:HANLON, MARY JANE (DMD)
Entity type:Individual
Prefix:DR
First Name:MARY JANE
Middle Name:
Last Name:HANLON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MARYJANE
Other - Middle Name:
Other - Last Name:HANLON-ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1111 S WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-4035
Mailing Address - Country:US
Mailing Address - Phone:603-210-4416
Mailing Address - Fax:
Practice Address - Street 1:1111 S WILLOW ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-4035
Practice Address - Country:US
Practice Address - Phone:603-210-4416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2025-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04908122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist