| NPI | 1629144589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE D FISHER Owner 302-644-2977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: DE 2000106563) |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2022-06-03 |