| NPI | 1922518059 |
|---|---|
| Doing Business As | SOUTHERN DELAWARE DENTAL SPECIALISTS |
| Entity Type | Organization |
| Authorized Contact | NANCY PANCKO Member 302-855-9499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 122300000X Dentist |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223P0300X Dentist, Periodontics | |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2017-10-03 |