Provider Demographics
NPI:1891826590
Name:HANNERS, W CHRIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:W CHRIS
Middle Name:
Last Name:HANNERS
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 1:559 S WEST ST
Mailing Address - Street 2:P.O. BOX 519
Mailing Address - City:PIKETON
Mailing Address - State:OH
Mailing Address - Zip Code:45661-8042
Mailing Address - Country:US
Mailing Address - Phone:740-289-4218
Mailing Address - Fax:
Practice Address - Street 1:559 S WEST ST
Practice Address - Street 2:
Practice Address - City:PIKETON
Practice Address - State:OH
Practice Address - Zip Code:45661-8042
Practice Address - Country:US
Practice Address - Phone:740-289-4218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0157581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0402862Medicaid