| NPI | 1316534076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN ROBINSON Owner 302-299-5617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-12-29 |
| Last Update Date | 2022-01-05 |