Provider Demographics
NPI:1922390079
Name:ABDELHALIM, TAREK (DDS,MSC,FACP)
Entity type:Individual
Prefix:DR
First Name:TAREK
Middle Name:
Last Name:ABDELHALIM
Suffix:
Gender:M
Credentials:DDS,MSC,FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9735 WILSHIRE BLVD STE 215
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2110
Mailing Address - Country:US
Mailing Address - Phone:310-271-5155
Mailing Address - Fax:310-247-1260
Practice Address - Street 1:9735 WILSHIRE BLVD STE 215
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2110
Practice Address - Country:US
Practice Address - Phone:310-271-5155
Practice Address - Fax:310-247-1260
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA512051223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics