Most Relevant Information
Provider Data
| NPI Number: | 1003027400 |
| Provider Name: | JACE C. HANSEN DMD, MS |
| Entity Type: | Individual |
| Taxonomy Code: | 1223P0300X |
| Specialty: | Dentist |
| License Number: | D-4290 |
Most Important Dates
| Enumeration Date: | 05/25/2007 |
| Last Updated: | 06/23/2021 |
Provider Practice Location
6019 N. EAGLE RD.
BOISE
ID
83713
Practice Location Phone/Fax
| Phone: | 2083772777 |
| Fax: | 2083773075 |
Provider Mailing Location
6019 N. EAGLE RD.
BOISE
ID
83713
Provider Mailing Phone/Fax
| Phone: | 2083772777 |
| Fax: | 2083773075 |