| NPI | 1568179034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY AMADIO Office Manager 302-737-6333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-11-03 |
| Last Update Date | 2022-11-03 |