Individual
BASAL K HASSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
119 SE 2ND ST, EVANSVILLE, IN 47708-1401
(812) 425-7025
Mailing address
119 SE 2ND ST, EVANSVILLE, IN 47708-1401
(812) 425-7025
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12013347A
IN
Other
Enumeration date
05/29/2020
Last updated
11/27/2023
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