Provider Demographics
NPI:1285016022
Name:WEHBE, HAITHAM (DMD)
Entity type:Individual
Prefix:
First Name:HAITHAM
Middle Name:
Last Name:WEHBE
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 1:19804 MORRIS AVE
Mailing Address - Street 2:STE 130
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-2867
Mailing Address - Country:US
Mailing Address - Phone:216-410-2805
Mailing Address - Fax:440-884-4393
Practice Address - Street 1:19804 MORRIS AVE,
Practice Address - Street 2:STE 130
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578
Practice Address - Country:US
Practice Address - Phone:216-410-2805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-28
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300245161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice