Provider Demographics
NPI:1023238359
Name:HANSKE, DAVID WILLIAM (DDS MS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAM
Last Name:HANSKE
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SO JACKSON ST
Mailing Address - Street 2:SUITE 135
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3131
Mailing Address - Country:US
Mailing Address - Phone:303-377-3548
Mailing Address - Fax:
Practice Address - Street 1:300 SO JACKSON ST
Practice Address - Street 2:SUITE 135
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3131
Practice Address - Country:US
Practice Address - Phone:303-377-3548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1053041223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics