Provider Demographics
NPI:1417166927
Name:TABAS, NORMAN B (DDS)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:B
Last Name:TABAS
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 1:2534 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-4615
Mailing Address - Country:US
Mailing Address - Phone:215-271-7776
Mailing Address - Fax:215-271-7040
Practice Address - Street 1:2534 S BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-4615
Practice Address - Country:US
Practice Address - Phone:215-271-7776
Practice Address - Fax:215-271-7040
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022116L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice