Provider Demographics
NPI:1790017150
Name:HANN-KECKLER, MICHAELANN M (RDH, PHDHP)
Entity Type:Individual
Prefix:
First Name:MICHAELANN
Middle Name:M
Last Name:HANN-KECKLER
Suffix:
Gender:F
Credentials:RDH, PHDHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OAK CREST CT
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-8020
Mailing Address - Country:US
Mailing Address - Phone:717-479-6968
Mailing Address - Fax:
Practice Address - Street 1:2 OAK CREST CT
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-8020
Practice Address - Country:US
Practice Address - Phone:717-479-6968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH069669124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist