Organization
CHILDREN'S DENTAL HEALTH OF DELAWARE - WILMINGTON, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VAN PHI LE (CREDENTIALING CONTRACTS MANAGER)
(267) 575-2321
Entity
Organization
Contact information
Practice address
708 FOULK RD, WILMINGTON, DE 19803-3734
(302) 764-7714
Mailing address
200 WILLOWBROOK LN STE 220, WEST CHESTER, PA 19382-5697
(267) 575-2321
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
G1-0000909
DE
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
G1-0000893
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000443701
—
DE
05
—
0000651508
—
DE
Enumeration date
01/08/2007
Last updated
02/10/2021
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