Provider Demographics
NPI:1750568614
Name:QUANSAH, JULIANA ABA (DDS)
Entity type:Individual
Prefix:DR
First Name:JULIANA
Middle Name:ABA
Last Name:QUANSAH
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 1:1928 E GENESEE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48601
Mailing Address - Country:US
Mailing Address - Phone:989-753-1993
Mailing Address - Fax:989-753-7959
Practice Address - Street 1:1928 E GENESEE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601
Practice Address - Country:US
Practice Address - Phone:989-753-1993
Practice Address - Fax:989-753-7959
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MID1254901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2796715Medicaid