Provider Demographics
NPI:1326168436
Name:HANSON, SHERRY CHU (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:CHU
Last Name:HANSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 NEWBURY ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-2703
Mailing Address - Country:US
Mailing Address - Phone:617-536-5182
Mailing Address - Fax:617-247-4498
Practice Address - Street 1:328 NEWBURY ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-2703
Practice Address - Country:US
Practice Address - Phone:617-536-5182
Practice Address - Fax:617-247-4498
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA211251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice