Provider Demographics
NPI:1013762582
Name:AL-GAHURI, ABDULHAFEDH (DDS)
Entity Type:Individual
Prefix:
First Name:ABDULHAFEDH
Middle Name:
Last Name:AL-GAHURI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1188 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14218-1817
Mailing Address - Country:US
Mailing Address - Phone:716-400-9423
Mailing Address - Fax:
Practice Address - Street 1:625 ELMWOOD AVE # 683
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2913
Practice Address - Country:US
Practice Address - Phone:585-275-5051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program