| NPI | 1679139448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI S HUSAIN Owner/President 302-838-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-05-16 |