NPI 1003858630

Guy M. Hanson, DDS, PA

Organisation Clinic/Center Boise, ID

Practice location

Address: 9203 W Overland Rd, Boise, ID 83709-2502
Phone: (208) 375-1012
Fax: (208) 375-1098

Authorised official

Name: Guy Matthew Hanson
Title: Owner
Phone: (208) 375-1012

Registered specialties

Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261Q00000X Licence D1850 (ID)

Other Clinic/Center providers in Idaho →

Registry record

NPI: 1003858630
Entity type: Organization
NPI issued: 11 Jun 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.