Provider Demographics
NPI:1104005404
Name:NOUMEH, TALAL A (DDS)
Entity Type:Individual
Prefix:DR
First Name:TALAL
Middle Name:A
Last Name:NOUMEH
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 1:1640 UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18109-1510
Mailing Address - Country:US
Mailing Address - Phone:610-776-7578
Mailing Address - Fax:610-776-7796
Practice Address - Street 1:1640 UNION BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18109-1510
Practice Address - Country:US
Practice Address - Phone:610-776-7578
Practice Address - Fax:610-776-7796
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027790L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012605790002Medicaid