Provider Demographics
NPI:1225503998
Name:HEBL, PETER ABRAHAM (DDS)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:ABRAHAM
Last Name:HEBL
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 1:2921 CROSLEY DR W APT G
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-8664
Mailing Address - Country:US
Mailing Address - Phone:414-573-3578
Mailing Address - Fax:
Practice Address - Street 1:956 S MILITARY TRL
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-3910
Practice Address - Country:US
Practice Address - Phone:561-725-7559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1001953-15122300000X
FLDN264471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist