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 |