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Individual

ISHMAEL HASAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
907 FRONTIER CIR E STE 100, LAKE STEVENS, WA 98258-2423
(425) 697-9219
Mailing address
PO BOX 58312, TUKWILA, WA 98138-1312

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DE60856783
WA
1223E0200X
Endodontics
DS044581
PA
1223G0001X
General Practice Dentistry
50 058325
NY

Other

Enumeration date
02/27/2013
Last updated
05/23/2024
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