Individual
DR. IQUEBAL HASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1851 MACGREGOR DOWNS RD, MAIL STOP #701, GREENVILLE, NC 27834-5925
(252) 737-7158
(252) 737-7049
Mailing address
1851 MACGREGOR DOWNS RO, MAIL STOP #701 ECU SCHOOL OF DENTAL MEDICINE, GREENVILLE, NC 27834-0297
(252) 737-7158
(252) 737-7049
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
00175
NC
1223G0001X
General Practice Dentistry
00175
NC
125Q00000X
Oral Medicine Dentistry
Primary
00175
NC
125Q00000X
Oral Medicine Dentistry
0175
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100301160
—
KY
Enumeration date
04/13/2010
Last updated
06/25/2020
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