| NPI | 1972720373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE T DERENZO Owner 302-475-3110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: DE G1-0001106) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2012-01-20 |