Provider Demographics
NPI:1760043194
Name:DEIBERT, AUBREY MAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:AUBREY
Middle Name:MAY
Last Name:DEIBERT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:
Other - Last Name:BEELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:338 W ALLEGAN ST
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MI
Mailing Address - Zip Code:49078-1012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:338 W ALLEGAN ST
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MI
Practice Address - Zip Code:49078-1012
Practice Address - Country:US
Practice Address - Phone:269-694-2074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901023151122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist