Provider Demographics
NPI:1689635484
Name:HANKS, ROBERT VON (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:VON
Last Name:HANKS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 C ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4000
Mailing Address - Country:US
Mailing Address - Phone:360-671-3836
Mailing Address - Fax:360-647-7540
Practice Address - Street 1:1800 C ST
Practice Address - Street 2:SUITE 225
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4000
Practice Address - Country:US
Practice Address - Phone:360-671-3836
Practice Address - Fax:360-647-7540
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA63651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA952152OtherUNITED CONCORDIA
WA5009055OtherDSHS PROVIDER