# MID-ATLANTIC DENTAL PARTNERS DELAWARE PROFESSIONAL ASSOCIATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295354165
- **Authorized official:** PAM HOLDER (SVP OF REVENUE CYCLE)
- **Authorized official phone:** (484) 243-6602

## Contact information

- **Practice address:** 2101 FOULK RD, WILMINGTON, DE 19810-4710
- **Practice address phone:** (302) 475-1122
- **Mailing address:** 630 W GERMANTOWN PIKE STE 120, PLYMOUTH MEETING, PA 19462-1074
- **Mailing address phone:** (720) 441-3423

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 04/10/2020
- **Last updated:** 04/10/2020