Provider Demographics
NPI:1952703761
Name:HASSAN, YASMINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:YASMINE
Middle Name:
Last Name:HASSAN
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 1:205 BAY DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-3102
Mailing Address - Country:US
Mailing Address - Phone:631-355-5555
Mailing Address - Fax:
Practice Address - Street 1:881 SOUTH ST
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-6252
Practice Address - Country:US
Practice Address - Phone:978-343-2630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1856744122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist