Organization
STATE OF DELAWARE
Active
Other names
Division of Public Health
Organization subpart
No
Provider details
NPI number
Authorized official
GARY ALSTON OWENS II (FISCAL MANAGER)
(302) 744-4861
Entity
Organization
Contact information
Practice address
417 FEDERAL ST, DOVER, DE 19901-3635
(302) 744-4849
(302) 739-1613
Mailing address
417 FEDERAL ST, DOVER, DE 19901-3635
(302) 744-4861
(302) 739-1613
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000117554
—
DE
Enumeration date
11/15/2006
Last updated
03/05/2026
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