| NPI | 1154481661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH T NGUYEN Owner 302-482-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DE G10000859 G10001149) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2014-01-13 |