Provider Demographics
NPI:1275044919
Name:USSI, ANNA (RDH)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:USSI
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15A REED ST
Mailing Address - Street 2:
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-1139
Mailing Address - Country:US
Mailing Address - Phone:774-242-0849
Mailing Address - Fax:
Practice Address - Street 1:15A REED ST
Practice Address - Street 2:
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1139
Practice Address - Country:US
Practice Address - Phone:774-242-0849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-20
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist