Provider Demographics
NPI:1730673146
Name:HANSEN, WILL JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILL
Middle Name:JOSEPH
Last Name:HANSEN
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 1:119 IVANHOE RD
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-4207
Mailing Address - Country:US
Mailing Address - Phone:319-483-8001
Mailing Address - Fax:
Practice Address - Street 1:107 ELDORA RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:IA
Practice Address - Zip Code:50643-7747
Practice Address - Country:US
Practice Address - Phone:319-988-4131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2021-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-09563122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist