Provider Demographics
NPI:1659810232
Name:CALLEN, HANNAH
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:CALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 W 20TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-3051
Mailing Address - Country:US
Mailing Address - Phone:970-373-4435
Mailing Address - Fax:970-771-8150
Practice Address - Street 1:5100 W 20TH ST STE B
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-3051
Practice Address - Country:US
Practice Address - Phone:970-373-4435
Practice Address - Fax:970-771-8150
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-16
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002048801223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry