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Blake Hansen, DDS

Dentist in Annapolis, MD. Individual provider (NPI-1).

NPI number1902531767
StatusActive
Last updated in NPPESJul 17, 2022

Details

NPI
1902531767
Entity type
Individual (NPI-1)
Name
Blake Hansen
Credential
DDS
Sex
Male
Sole proprietor
Yes
Enumeration date
Jul 17, 2022
Certification date
Jul 17, 2022
Last updated
Jul 17, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist17622MDYes

Practice location

18 Brewer Ave
Annapolis, MD 21401-3307

Phone 308-760-6376

Mailing address

18 Brewer Ave
Annapolis, MD 21401-3307

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