| NPI | 1538866108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP JAMES LOUIE Owner 302-674-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2023-02-14 |
| Last Update Date | 2024-01-24 |