Provider Demographics
NPI:1962667063
Name:BIEBER, THOMAS W (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:BIEBER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7544 W NORTH AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-4166
Mailing Address - Country:US
Mailing Address - Phone:708-456-8860
Mailing Address - Fax:708-456-9585
Practice Address - Street 1:7544 W NORTH AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-4166
Practice Address - Country:US
Practice Address - Phone:708-456-8860
Practice Address - Fax:708-456-9585
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-021290122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist