Provider Demographics
NPI:1447676358
Name:NUR, HASSAN (DMD)
Entity type:Individual
Prefix:DR
First Name:HASSAN
Middle Name:
Last Name:NUR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5632 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2737
Mailing Address - Country:US
Mailing Address - Phone:443-850-0079
Mailing Address - Fax:
Practice Address - Street 1:5632 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2737
Practice Address - Country:US
Practice Address - Phone:443-850-0079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-16
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15404122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist