Theodore J Deibel, DMD

NPI #1033108444 in Clayton, Missouri

Provider Information

NPI Number: 1033108444
Entity Type: Individual
Name: Theodore J Deibel, DMD
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Oct 18, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 8000 BONHOMME AVE
Address 2: SUITE 422
City: Clayton
State: Missouri
ZIP Code: 63105-3515
Phone: (314) 725-6999

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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