Provider Demographics
NPI:1194872093
Name:AUBERT, MARYSE MICHELLE (MARYSE AUBERT, DDS)
Entity type:Individual
Prefix:DR
First Name:MARYSE
Middle Name:MICHELLE
Last Name:AUBERT
Suffix:
Gender:F
Credentials:MARYSE AUBERT, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1565 HOLLENBECK AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-5922
Mailing Address - Country:US
Mailing Address - Phone:408-737-0660
Mailing Address - Fax:408-737-0614
Practice Address - Street 1:1565 HOLLENBECK AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-5922
Practice Address - Country:US
Practice Address - Phone:408-737-0660
Practice Address - Fax:408-737-0614
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA337231223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics