Provider Demographics
NPI:1568985950
Name:MAYNE, DEBORAH ALBERS (DMD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ALBERS
Last Name:MAYNE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:ALBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1468 BACKER WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-2571
Mailing Address - Country:US
Mailing Address - Phone:775-636-0178
Mailing Address - Fax:
Practice Address - Street 1:5150 MAE ANNE AVE STE 810A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-1881
Practice Address - Country:US
Practice Address - Phone:775-747-0680
Practice Address - Fax:775-747-0681
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA607626591223G0001X
NV74591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice