Provider Demographics
NPI:1134204258
Name:VANHUSS, ERIC B (DMD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:B
Last Name:VANHUSS
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 1:6842 MORRISON BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-3547
Mailing Address - Country:US
Mailing Address - Phone:704-362-4095
Mailing Address - Fax:704-362-4099
Practice Address - Street 1:6842 MORRISON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-3547
Practice Address - Country:US
Practice Address - Phone:704-362-4095
Practice Address - Fax:704-362-4099
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC37291223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics