Individual
HANI MASSOUD HANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 KNEELAND ST, BOSTON, MA 02111-1527
(617) 636-6828
Mailing address
179 PRESIDENTS LN UNIT 2G, QUINCY, MA 02169-1979
(703) 479-9010
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
1111111
MA
Other
Enumeration date
06/19/2017
Last updated
06/19/2017
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