Provider Demographics
NPI:1861722993
Name:ABUHUSSEIN, HEBA (BDS)
Entity type:Individual
Prefix:
First Name:HEBA
Middle Name:
Last Name:ABUHUSSEIN
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 COLUMBUS DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-2791
Mailing Address - Country:US
Mailing Address - Phone:734-883-6095
Mailing Address - Fax:
Practice Address - Street 1:290 COLUMBUS DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-2791
Practice Address - Country:US
Practice Address - Phone:734-883-6095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010200561223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics