Provider Demographics
NPI:1619973716
Name:HANNA, NASSER S I (DDS)
Entity Type:Individual
Prefix:DR
First Name:NASSER
Middle Name:S
Last Name:HANNA
Suffix:I
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:MA
Mailing Address - Zip Code:01562-1839
Mailing Address - Country:US
Mailing Address - Phone:508-885-5511
Mailing Address - Fax:508-885-7665
Practice Address - Street 1:284 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:MA
Practice Address - Zip Code:01562-1839
Practice Address - Country:US
Practice Address - Phone:508-885-5511
Practice Address - Fax:508-885-7665
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA202121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice