| NPI | 1578691838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LUCKENBAUGH Doctor/Owner Of The Practice 302-645-6671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DE 769) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2022-09-15 |