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Organization
NEWBURGH MODERN DENTISTRY LLC
Active
Organization
NEWBURGH MODERN DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BASAL K HASSAN DDS (OWNER)
(812) 616-5444
Entity
Organization
Contact information
Practice address
3944 STATE ROAD 261, NEWBURGH, IN 47630
(812) 616-5444
Mailing address
3944 STATE ROAD 261, NEWBURGH, IN 47630
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/29/2022
Last updated
10/10/2022
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