Provider Demographics
NPI:1740700129
Name:MOHAMED, ABDELRAHMAN ALAA ELDIN LABIB (DDS)
Entity type:Individual
Prefix:DR
First Name:ABDELRAHMAN
Middle Name:ALAA ELDIN LABIB
Last Name:MOHAMED
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 1:801 ELM ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-2103
Mailing Address - Country:US
Mailing Address - Phone:603-623-7800
Mailing Address - Fax:
Practice Address - Street 1:801 ELM ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-2103
Practice Address - Country:US
Practice Address - Phone:603-623-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04326122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist