Organization
PENINSULA DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN T. MOORE (OFFICE MANAGER)
(302) 297-3750
Entity
Organization
Contact information
Practice address
26670 CENTERVIEW DR UNIT 19, MILLSBORO, DE 19966-3584
(302) 297-3750
Mailing address
26670 CENTERVIEW DR UNIT 19, MILLSBORO, DE 19966-3584
(302) 297-3750
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2009603113
DE
Other
Enumeration date
06/25/2009
Last updated
06/25/2009
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