Provider Demographics
NPI:1588683361
Name:HANNA, RAY YOUSRY (DMD)
Entity type:Individual
Prefix:DR
First Name:RAY
Middle Name:YOUSRY
Last Name:HANNA
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 1:38 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-3203
Mailing Address - Country:US
Mailing Address - Phone:618-887-1400
Mailing Address - Fax:617-887-1401
Practice Address - Street 1:38 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-3203
Practice Address - Country:US
Practice Address - Phone:618-887-1400
Practice Address - Fax:617-887-1401
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA199681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice