Provider Demographics
NPI:1225856362
Name:TABEL, OMER (DDS)
Entity type:Individual
Prefix:DR
First Name:OMER
Middle Name:
Last Name:TABEL
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 1:27310 STONEHENGE CIR
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-8189
Mailing Address - Country:US
Mailing Address - Phone:951-312-7863
Mailing Address - Fax:
Practice Address - Street 1:27310 STONEHENGE CIR
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-8189
Practice Address - Country:US
Practice Address - Phone:951-312-7863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110645122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist