Provider Demographics
NPI:1750169249
Name:MOHAMMED SALIH, HASSAN MARWAN (DDS)
Entity type:Individual
Prefix:
First Name:HASSAN
Middle Name:MARWAN
Last Name:MOHAMMED SALIH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:HASSAN
Other - Middle Name:MARWAN
Other - Last Name:MOHAMMED SALIH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HASSAN MARWAN
Mailing Address - Street 1:6765 CROFTON DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-8358
Mailing Address - Country:US
Mailing Address - Phone:678-640-2871
Mailing Address - Fax:
Practice Address - Street 1:2221 JOHNSON FERRY RD NE UNIT 2A
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-2203
Practice Address - Country:US
Practice Address - Phone:404-200-7341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH048691223G0001X
GADN123518122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty