Provider Demographics
NPI:1134347222
Name:HANSMANN, WILLIAM ROBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ROBERT
Last Name:HANSMANN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2686 SCOBEE DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-7211
Mailing Address - Country:US
Mailing Address - Phone:770-977-1632
Mailing Address - Fax:770-578-8140
Practice Address - Street 1:3823 ROSWELL RD
Practice Address - Street 2:SUITE 104
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-6278
Practice Address - Country:US
Practice Address - Phone:770-977-1632
Practice Address - Fax:770-578-8140
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL200801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice