Provider Demographics
NPI:1013341916
Name:ABOUHASSAN, HANAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:HANAN
Middle Name:
Last Name:ABOUHASSAN
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 1:6882 FENTON ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2117
Mailing Address - Country:US
Mailing Address - Phone:248-982-0832
Mailing Address - Fax:
Practice Address - Street 1:35220 MOUND RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4717
Practice Address - Country:US
Practice Address - Phone:586-825-0388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901021080122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist