MEDICARE: RANA HANNA DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2901021688	MI

General Provider Information

NPI Number	:	1184024986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANA HANNA DMD

Provider Business Mailing Address
First Line	:	34514 DEQUINDRE RD STE B
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-5232
Country	:	US
Telephone Number	:	774-345-0835
Fax Number	:

Provider Business Practice Location Address
First Line	:	34514 DEQUINDRE RD STE B
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-5232
Country	:	US
Telephone Number	:	586-981-0199
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2014
Last Update Date	:	10/04/2016

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