| NPI | 1306115597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA MARIE MAZOCH President/Dentist 302-998-9594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DE G1-001096) |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2011-12-19 |