Individual
AMMAR IDLIBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
733 TERRYVILLE AVE, BRISTOL, CT 06010-4034
(860) 584-0441
(860) 516-8918
Mailing address
733 TERRYVILLE AVE, BRISTOL, CT 06010-4034
(860) 584-0441
(860) 516-8918
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
P07893
CT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
PO7893
CT
Other
Enumeration date
07/14/2006
Last updated
10/14/2008
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