Provider Demographics
NPI:1114053949
Name:HASSON, DAVID MICHAEL (DMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MICHAEL
Last Name:HASSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 CENTER ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-7420
Mailing Address - Country:US
Mailing Address - Phone:301-829-6588
Mailing Address - Fax:301-829-6338
Practice Address - Street 1:602 CENTER ST
Practice Address - Street 2:SUITE 203
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-7420
Practice Address - Country:US
Practice Address - Phone:301-829-6588
Practice Address - Fax:301-829-6338
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD93661223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry