Provider Demographics
NPI:1316903297
Name:GO, HANS A (DMD)
Entity type:Individual
Prefix:DR
First Name:HANS
Middle Name:A
Last Name:GO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9555 SW BARNES RD.,
Mailing Address - Street 2:SUITE 355
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6670
Mailing Address - Country:US
Mailing Address - Phone:503-296-0053
Mailing Address - Fax:503-297-2057
Practice Address - Street 1:9555 SW BARNES RD.,
Practice Address - Street 2:SUITE 355
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6670
Practice Address - Country:US
Practice Address - Phone:503-296-0053
Practice Address - Fax:503-297-2057
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORD66091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice