| NPI | 1265083315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD JEREMY HAMMOND Officer 302-983-9707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2022-07-27 |