Provider Demographics
NPI:1215716030
Name:HANSON, DEANN (RDH)
Entity type:Individual
Prefix:
First Name:DEANN
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:DEANN
Other - Middle Name:
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:517 COURT ST RM 105
Mailing Address - Street 2:
Mailing Address - City:NEILLSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54456-1982
Mailing Address - Country:US
Mailing Address - Phone:715-743-5105
Mailing Address - Fax:715-743-5115
Practice Address - Street 1:517 COURT ST RM 105
Practice Address - Street 2:
Practice Address - City:NEILLSVILLE
Practice Address - State:WI
Practice Address - Zip Code:54456-1982
Practice Address - Country:US
Practice Address - Phone:715-743-5105
Practice Address - Fax:715-743-5115
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11453-16124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist