Provider Demographics
NPI:1912057001
Name:KLEIN, DEBORA S (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBORA
Middle Name:S
Last Name:KLEIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 N RAND RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-1496
Mailing Address - Country:US
Mailing Address - Phone:847-277-0090
Mailing Address - Fax:847-277-0060
Practice Address - Street 1:428 N RAND RD
Practice Address - Street 2:
Practice Address - City:NORTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1496
Practice Address - Country:US
Practice Address - Phone:847-277-0090
Practice Address - Fax:847-277-0060
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice