| NPI | 1235594268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE AHL Owner / President 302-678-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: DE 2012102541) |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2015-12-17 |