Provider Demographics
NPI:1902464357
Name:EIBLING, VALERIE M
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:M
Last Name:EIBLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17567 RIVER AVENUE
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-6081
Mailing Address - Country:US
Mailing Address - Phone:317-773-2983
Mailing Address - Fax:
Practice Address - Street 1:17567 RIVER AVENUE
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062
Practice Address - Country:US
Practice Address - Phone:317-773-2983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013173A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist