Hanson, Peter Michael

Hanson, Peter Michael is an individual health care provider with primary practice located at 1503 Randolph Ct , Manitowoc WI 54220-8345. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Hanson, Peter Michael can be contacted via phone (920) 682-0321.

Contact Information

Primary practice address
1503 Randolph Ct Manitowoc WI 54220-8345
Phone: (920) 682-0321
Fax: (920) 682-3128
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 1679G Wisconsin

Profile Details

NPI number 1689666232
LBN Legal business name Hanson, Peter Michael
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689666232 NPPES
Wisconsin MEDICAID 33545500

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