Provider Demographics
NPI:1467641928
Name:HANHILA AND HANHILA DDS PC
Entity Type:Organization
Organization Name:HANHILA AND HANHILA DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:O
Authorized Official - Last Name:HANHILA
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-279-2981
Mailing Address - Street 1:1515 E MISSOURI AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-2446
Mailing Address - Country:US
Mailing Address - Phone:602-279-2298
Mailing Address - Fax:602-279-1074
Practice Address - Street 1:1515 E MISSOURI AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2446
Practice Address - Country:US
Practice Address - Phone:602-279-2981
Practice Address - Fax:602-279-1074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD4468261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental