Provider Demographics
NPI:1942579768
Name:HAN, FRANCIS SANGIK (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:SANGIK
Last Name:HAN
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 1:360 BOSTON AVE STE 17
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-5213
Mailing Address - Country:US
Mailing Address - Phone:203-375-1388
Mailing Address - Fax:
Practice Address - Street 1:158 ENGLISH ST UNIT A
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6904
Practice Address - Country:US
Practice Address - Phone:347-216-5641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-22
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0106001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1942579768Medicaid