| NPI | 1568991636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN S BIBKO Orthodontist 203-866-7806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2017-06-12 |