| NPI | 1861724809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORRINE FARROW Office Director 302-463-0906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MD 6041) |
| Enumeration Date | 2010-02-01 |
| Last Update Date | 2010-02-01 |