Individual provider · Type 1 NPI

Callie Jo Hanson, RDH, MDT

Dental Therapist · Mankato, MN

NPI number 1043949860 Active

Practice location

309 Holly Ln
Mankato, MN 56001-5422

Call (507) 388-2120 Map

Mailing address

3502 Hoeger Ln
Albert Lea, MN 56007-4220

Specialties and licenses

TaxonomyCodeLicense
Dental Hygienist 124Q00000XH11186 (MN)
Dental Therapist Primary 125J00000XDT151 (MN)

Dental Therapist: A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therap…

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About NPI 1043949860

Callie Jo Hanson, RDH, MDT's National Provider Identifier is 1043949860, issued on Jun 7, 2022. The primary taxonomy on file is Dental Therapist (125J00000X), and the practice location is in Mankato, MN. The record was last updated on Jun 28, 2022.