NPI | 1326728825 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMMY EVANS Practice Manager 302-328-6777 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
Enumeration Date | 2023-07-19 |
Last Update Date | 2023-07-19 |