| NPI | 1821656471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE CERNOBYL Director Of Operations 302-392-2449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2019-05-30 |