Provider Demographics
NPI:1326117698
Name:HAN, CYNTHIA B (DDS)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:B
Last Name:HAN
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 1:640 N RIVER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8969
Mailing Address - Country:US
Mailing Address - Phone:630-355-3355
Mailing Address - Fax:630-355-2953
Practice Address - Street 1:640 N RIVER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8969
Practice Address - Country:US
Practice Address - Phone:630-355-3355
Practice Address - Fax:630-355-2953
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0190841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice