Individual
MARK A. HANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
55 MAIN ST, FRAMINGHAM, MA 01702-2934
(508) 875-0400
Mailing address
46 AZALEA RD, SHARON, MA 02067-3214
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20011
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X11874
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/15/2006
Last updated
08/29/2007
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