| NPI | 1548705197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND PETRUNICH Owner 302-690-8822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DE 1136) |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2017-01-05 |