| NPI | 1750435350 |
|---|---|
| Doing Business As | PARK PLACE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JOHN N RUSSO Owner 302-652-3775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DE gi0000719) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DE gi0001031) |
| 1223G0001X Dentist, General Practice (Licence: DE gi00001157) | |
| 1223G0001X Dentist, General Practice (Licence: DE gi00001156) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-08-22 |