Provider Demographics
NPI:1194038646
Name:DIBNER, AURORA CLARK (DMD)
Entity Type:Individual
Prefix:DR
First Name:AURORA
Middle Name:CLARK
Last Name:DIBNER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 CROSS RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06385-1204
Mailing Address - Country:US
Mailing Address - Phone:860-447-1787
Mailing Address - Fax:
Practice Address - Street 1:112 CROSS RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-1204
Practice Address - Country:US
Practice Address - Phone:860-447-1787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT111451223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics