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Individual

DR. BIANCA ANNE HASSOUN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7117 GREEN BAY RD, KENOSHA, WI 53142
(262) 942-7000
Mailing address
7117 GREEN BAY RD, KENOSHA, WI 53142-1450

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1002624
WI

Other

Enumeration date
06/22/2017
Last updated
07/07/2021
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