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NPI Code Detail

MEDICARE: DR. BRYAN M VIBETO DDS

MEDICARE:  DR. BRYAN M VIBETO  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry11516MN
21223X0400XOrthodontics and Dentofacial Orthopedics Dentistry1979ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053385468
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRYAN M VIBETO DDS
Provider Business Mailing Address
First Line : 2615 ELK DR STE 2
Second Line :
City : MINOT
State : ND
Zip : 58701-1200
Country : US
Telephone Number : 701-839-6010
Fax Number :
Provider Business Practice Location Address
First Line : 2615 ELK DR
Second Line : STE 2
City : MINOT
State : ND
Zip : 58701-0001
Country : US
Telephone Number : 701-839-6010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 07/16/2008

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Directions to “ DR. BRYAN M VIBETO DDS” Practice Location

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