Provider Demographics
NPI:1023401544
Name:RAUF, HASEEB ALI (DMD)
Entity Type:Individual
Prefix:DR
First Name:HASEEB
Middle Name:ALI
Last Name:RAUF
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 1:1803 HARTNESS DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5494
Mailing Address - Country:US
Mailing Address - Phone:704-813-4015
Mailing Address - Fax:704-813-4015
Practice Address - Street 1:1803 HARTNESS DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5494
Practice Address - Country:US
Practice Address - Phone:704-813-4015
Practice Address - Fax:704-813-4015
Is Sole Proprietor?:No
Enumeration Date:2015-03-08
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
SC95921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program