Provider Demographics
NPI:1093999856
Name:HANNAHAN, ANDREA LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:LYNN
Last Name:HANNAHAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012C CROSSINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-2787
Mailing Address - Country:US
Mailing Address - Phone:931-487-9997
Mailing Address - Fax:931-487-9998
Practice Address - Street 1:1012C CROSSINGS BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2787
Practice Address - Country:US
Practice Address - Phone:931-487-9997
Practice Address - Fax:931-487-9998
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS8581122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist