Individual
JOSHUA HASSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
2100 MILLER PARK WAY, WEST MILWAUKEE, WI 53219-1641
(908) 812-2220
Mailing address
3012 W JARVIS AVE, CHICAGO, IL 60645-1112
(908) 812-2220
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.031082
IL
122300000X
Dentist
319.020434
IL
1223P0300X
Periodontics
Primary
1001750-15
WI
Other
Enumeration date
03/04/2016
Last updated
04/17/2018
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