Hani M Aboufoul, DMD

Individual provider Active NPI Public Health Dentistry · Charlotte, NC

NPI 1790701308 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1790701308
Entity type
Individual (NPI type 1)
Primary specialty
Public Health Dentistry 1223D0001X
License
NC6417 (NC)
Practice address
1801 Rozzelles Ferry Rd
Charlotte, NC 28208-4228
Phone
(704) 350-7300
Fax
(704) 350-7304
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
NC6417NCMDPublic Health Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X NC6417 NC Yes

Addresses

Primary practice location

1801 Rozzelles Ferry Rd
Charlotte, NC 28208-4228

Mailing address

1801 Rozzelles Ferry Rd
Charlotte, NC 28208-4228
Phone (704) 350-7300

Other identifiers

IdentifierTypeStateIssuer
5901085MedicaidNC
015N0OtherNCNC HEALTHCHOICE

Other providers in Charlotte, NC

All providers in Charlotte, NC · Public Health Dentistry in North Carolina

Sources for this page

Verify at the official NPI Registry.