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General NPI Number Information
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NPI Number | 1295095008
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Entity Type | Individual
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Provider Name | HASSAN ABDULWAHID D.D.S
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Gender | Male
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Dates
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Enumeration Date | 05/26/2012
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Last Update Date | 05/26/2012
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Provider Practice Location Address
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Address Line | 1725 E SHERMAN BLVD
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City | MUSKEGON
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State | MI
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Zip | 49444-1862
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Country | US
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Telephone | 313-463-1801
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Fax |
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Provider Business Mailing Address
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Address Line | 430 W ERIE ST STE 200
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City | CHICAGO
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State | IL
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Zip | 60654-6914
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Country | US
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Telephone | 313-463-1801
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901020654
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License Number State | MI
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