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Individual

DR. OLEG TABAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
500 RIVER AVE, SUITE 240, LAKEWOOD, NJ 08701-4738
(732) 364-5505
(732) 364-5595
Mailing address
500 RIVER AVE, SUITE 240, LAKEWOOD, NJ 08701-4738
(732) 364-5505
(732) 364-5595

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
048956-1
NY
1223G0001X
General Practice Dentistry
Primary
22DI02295200
NJ

Other

Enumeration date
07/01/2006
Last updated
05/05/2010
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