Individual provider · Type 1 NPI

Larry Jay Hanson, DDS

Oral and Maxillofacial Surgery (Dentist) · Fort Gordon, GA

NPI number 1366424624 Active

Practice location

Bldg 38717 38th Street, Usa Dentac
Fort Gordon, GA 30905-5660

Call (706) 787-6927 Map

Fax (706) 787-2082

Specialties and licenses

TaxonomyCodeLicense
Dentist 122300000X06671 (IA)
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X06671 (IA)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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About NPI 1366424624

Larry Jay Hanson, DDS's National Provider Identifier is 1366424624, issued on Nov 14, 2005. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Fort Gordon, GA. The record was last updated on Sep 11, 2025.