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General NPI Number Information
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NPI Number | 1184184624
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Entity Type | Individual
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Provider Name | MICHAEL HANNA DDS
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Gender | Male
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 23 BOND ST STE 8
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City | GREAT NECK
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State | NY
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Zip | 11021-2025
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Country | US
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Telephone | 516-482-0329
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Fax |
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Provider Business Mailing Address
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Address Line | 350 HERB HILL RD
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City | GLEN COVE
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State | NY
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Zip | 11542-4415
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Country | US
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Telephone | 860-514-1243
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 063267
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License Number State | NY
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