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 |