Organization · Type 2 NPI
Bryce D Hanson, DMD PA
Dental Clinic/Center · Shelley, ID
NPI number
1851798045
Active
Practice location
371 W Fir St
Shelley, ID 83274-1456
Fax (208) 357-1805
Mailing address
PO Box 525
Shelley, ID 83274-0525
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | D-3275 (ID) |
Dental Clinic/Center: Definition to come...
3 other providers at this address
About NPI 1851798045
Bryce D Hanson, DMD PA's National Provider Identifier is 1851798045, issued on Dec 3, 2014. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Shelley, ID. The record was last updated on Dec 3, 2014.