| NPI | 1013145366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN T. MOORE Office Manager 302-297-3750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DE 2009603113) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2009-06-25 |