Provider Demographics
NPI:1144383092
Name:CHAB, ABE (DMD)
Entity Type:Individual
Prefix:MR
First Name:ABE
Middle Name:
Last Name:CHAB
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:MR
Other - First Name:HOSAM
Other - Middle Name:
Other - Last Name:ABOCHHAB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:317 SOUTH HILL STREET
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224
Mailing Address - Country:US
Mailing Address - Phone:770-227-1865
Mailing Address - Fax:770-227-1920
Practice Address - Street 1:317 SOUTH HILL STREET
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224
Practice Address - Country:US
Practice Address - Phone:770-227-1865
Practice Address - Fax:770-227-1920
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-022416122300000X
GADN013471122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty