Provider Demographics
NPI:1942071345
Name:HANFT, KILEY KAE
Entity Type:Individual
Prefix:
First Name:KILEY
Middle Name:KAE
Last Name:HANFT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 E BURLINGTON ST APT C
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-5116
Mailing Address - Country:US
Mailing Address - Phone:641-425-7638
Mailing Address - Fax:
Practice Address - Street 1:713 E BURLINGTON ST APT C
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-5116
Practice Address - Country:US
Practice Address - Phone:641-425-7638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant