Provider Demographics
NPI:1902261290
Name:HANZES, BETH ANN (RHD, PHDHP)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ANN
Last Name:HANZES
Suffix:
Gender:F
Credentials:RHD, PHDHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 SOUTHWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401
Mailing Address - Country:US
Mailing Address - Phone:724-366-1719
Mailing Address - Fax:
Practice Address - Street 1:118 SOUTHWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401
Practice Address - Country:US
Practice Address - Phone:724-366-1719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPH008645L124Q00000X
PAPHDH000491124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist