Provider Demographics
NPI:1164648416
Name:KLEIBER, DIANE G (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:G
Last Name:KLEIBER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 N ELM ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3634
Mailing Address - Country:US
Mailing Address - Phone:630-323-0060
Mailing Address - Fax:630-323-0030
Practice Address - Street 1:911 N ELM ST
Practice Address - Street 2:SUITE 225
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3634
Practice Address - Country:US
Practice Address - Phone:630-323-0060
Practice Address - Fax:630-323-0030
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice