Provider Demographics
NPI:1548365455
Name:HANHILA, BRIDGET FIELDS (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:FIELDS
Last Name:HANHILA
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 1:1515 E MISSOURI AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-2446
Mailing Address - Country:US
Mailing Address - Phone:602-279-2981
Mailing Address - Fax:602-279-1074
Practice Address - Street 1:1515 E MISSOURI AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2446
Practice Address - Country:US
Practice Address - Phone:602-279-2981
Practice Address - Fax:602-279-1074
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZARIZ D44671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice