# PETRUNICH ORAL SURGERY

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

## Provider details

- **NPI number:** 1548705197
- **Authorized official:** RAYMOND PETRUNICH DDS (OWNER)
- **Authorized official phone:** (302) 690-8822

## Contact information

- **Practice address:** 2444 PULASKI HWY \# 100, NEWARK, DE 19702-3906
- **Practice address phone:** (302) 836-3565
- **Practice address fax:** (302) 836-0868
- **Mailing address:** 2444 PULASKI HWY \# 100, NEWARK, DE 19702-3906

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 1136 | DE | Yes |

## Other

- **Enumeration date:** 01/05/2017
- **Last updated:** 01/05/2017