| NPI | 1902935000 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | VICTOR L. GREGORY Employer 302-239-1827 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DE G10001003) | 
| Enumeration Date | 2007-03-05 | 
| Last Update Date | 2025-04-29 |