Provider Demographics
NPI:1992357008
Name:HANNA, KAYLA DAWN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:DAWN
Last Name:HANNA
Suffix:
Gender:F
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:PO BOX 711
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-0711
Mailing Address - Country:US
Mailing Address - Phone:785-443-2520
Mailing Address - Fax:
Practice Address - Street 1:6703 S LOUISE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5982
Practice Address - Country:US
Practice Address - Phone:605-271-9330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-10
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS61624122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist