NPI | 1013076967 |
---|---|
Entity Type | Organization |
Authorized Contact | CONNIE F CICORELLI Owner 302-798-5797 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: DE G1-0000958) |
Enumeration Date | 2006-12-07 |
Last Update Date | 2007-08-27 |