Provider Demographics
NPI:1720099120
Name:HANNON, DENNIS (DDS)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:HANNON
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 1:262 COTTAGE ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-4143
Mailing Address - Country:US
Mailing Address - Phone:603-444-0003
Mailing Address - Fax:603-444-9401
Practice Address - Street 1:262 COTTAGE ST
Practice Address - Street 2:SUITE 301
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-4143
Practice Address - Country:US
Practice Address - Phone:603-444-0003
Practice Address - Fax:603-444-9401
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH34751223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30304273Medicaid