Organization
HEARTLAND PERIODONTAL & DENTAL IMPLANT CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOSTAFA TABAA DDS (PERIODONTIST/DENTIST)
(513) 856-8252
Entity
Organization
Contact information
Practice address
5850 BOYMEL DR STE 2, FAIRFIELD, OH 45014-5500
(513) 856-8252
(513) 805-7086
Mailing address
5850 BOYMEL DR STE 2, FAIRFIELD, OH 45014-5500
(513) 856-8252
(513) 805-7086
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
02/26/2026
Last updated
02/26/2026
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