Provider Demographics
NPI:1629815659
Name:ANDRIES, HANNAH (DDS)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:ANDRIES
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 1:402 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-2965
Mailing Address - Country:US
Mailing Address - Phone:218-829-4243
Mailing Address - Fax:218-825-8102
Practice Address - Street 1:402 JAMES ST
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-2965
Practice Address - Country:US
Practice Address - Phone:218-829-4243
Practice Address - Fax:218-825-8102
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND151401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice