| NPI | 1801936281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY M CLOUGH Office Manager 302-658-7354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: DE G-1000612) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |