Individual
THEODORE J DEIBEL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8000 BONHOMME AVE, SUITE 422, CLAYTON, MO 63105-3515
(314) 725-6999
Mailing address
8000 BONHOMME AVE, SUITE 422, CLAYTON, MO 63105-3515
(314) 725-6999
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12133
MO
Other
Enumeration date
10/18/2005
Last updated
07/08/2007
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