Individual
DR. DEAN TIBORIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5021 WASHINGTON RD, KENOSHA, WI 53144-4292
(262) 654-6770
(262) 654-6727
Mailing address
5021 WASHINGTON RD, KENOSHA, WI 53144-4292
(262) 654-6770
(262) 654-6727
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
7210-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/09/2010
Last updated
06/10/2014
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