Provider Demographics
NPI:1629268099
Name:SOBIESKI SCHAUBER, VICKI S (DMD)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:S
Last Name:SOBIESKI SCHAUBER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BROOKRIDGE LANE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-2952
Mailing Address - Country:US
Mailing Address - Phone:302-239-9829
Mailing Address - Fax:
Practice Address - Street 1:333 SHIPLEY STREET
Practice Address - Street 2:
Practice Address - City:WILLMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801
Practice Address - Country:US
Practice Address - Phone:302-571-5364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDE1038122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist