Individual
MASSARA HASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5220 CENTRAL AVE NE STE 240, COLUMBIA HEIGHTS, MN 55421-1823
(763) 275-1319
Mailing address
675 STATION BLVD APT 204, AURORA, IL 60504-4047
(630) 492-3894
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.033236
IL
122300000X
Dentist
Primary
D14681
MN
Other
Enumeration date
07/14/2021
Last updated
01/13/2022
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