Individual
DR. HASSAN ISMAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1090 SHINGLE CREEK CROSSING, ASPEN DENTAL, BROOKLYN CENTER, MN 55340
(651) 583-7256
Mailing address
1090 SHINGLE CREEK CROSSING, ASPEN DENTAL, BROOKLYN CENTER, MN 55430
(651) 583-7256
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12061
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
611890900
MEDICAL ASSISTANCE NUMBER
MN
Enumeration date
01/18/2007
Last updated
03/27/2015
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