Provider Demographics
NPI:1164450292
Name:MAKHLOUF, MARY (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:MAKHLOUF
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-3021
Mailing Address - Country:US
Mailing Address - Phone:336-226-8406
Mailing Address - Fax:336-226-9281
Practice Address - Street 1:215 E ELM ST
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253-3021
Practice Address - Country:US
Practice Address - Phone:336-226-8406
Practice Address - Fax:336-226-9281
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC57671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice