Tibbetts, John Raschen

Tibbetts, John Raschen is an individual health care provider with primary practice located at 5353 Main St , Williamsville NY 14221-5337. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Tibbetts, John Raschen can be contacted via phone (716) 634-3511.

Contact Information

Primary practice address
5353 Main St Williamsville NY 14221-5337
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 044104 New York

Profile Details

NPI number 1033112800
LBN Legal business name Tibbetts, John Raschen
Credentials D.D.S., M.S.
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033112800 NPPES
New York MEDICAID 01543782

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