Provider Demographics
NPI:1811032295
Name:CARBERRY, DEBRA LON (DMD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:LON
Last Name:CARBERRY
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 1:4328 NORTHERN PIKE
Mailing Address - Street 2:SUITE #102
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2825
Mailing Address - Country:US
Mailing Address - Phone:412-856-8200
Mailing Address - Fax:
Practice Address - Street 1:4328 NORTHERN PIKE
Practice Address - Street 2:SUITE #102
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2825
Practice Address - Country:US
Practice Address - Phone:412-856-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019524-L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics