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Organization
FIRST STATE ORAL AND MAXILLOFACIAL SURGERY CORP
Active
Organization
FIRST STATE ORAL AND MAXILLOFACIAL SURGERY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS LYNN DITTY DMD, MD (OWNER)
(302) 674-4450
Entity
Organization
Contact information
Practice address
1004 S STATE ST STE 1, DOVER, DE 19901-6901
(302) 674-4450
(302) 678-3228
Mailing address
1004 S STATE ST STE 1, DOVER, DE 19901-6901
(302) 674-4450
(302) 678-3228
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
G100093
DE
Other
Enumeration date
03/28/2007
Last updated
11/05/2019
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