Provider Demographics
NPI:1730278383
Name:DENNIS, TROY HANSON (DMD)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:HANSON
Last Name:DENNIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 8TH AVE SW
Mailing Address - Street 2:P. O. BOX 326
Mailing Address - City:CHILDERSBURG
Mailing Address - State:AL
Mailing Address - Zip Code:35044-1625
Mailing Address - Country:US
Mailing Address - Phone:256-378-5442
Mailing Address - Fax:256-378-5427
Practice Address - Street 1:311 8TH AVE SW
Practice Address - Street 2:
Practice Address - City:CHILDERSBURG
Practice Address - State:AL
Practice Address - Zip Code:35044-1625
Practice Address - Country:US
Practice Address - Phone:256-378-5442
Practice Address - Fax:256-378-5427
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL49161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL631203117Other631203117