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Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
77 SAULSBURY RD, DOVER, DE 19904-3444
(302) 678-2942
Mailing address
77 SAULSBURY RD, DOVER, DE 19904-3444
(302) 678-2942

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
G1-0011520
DE

Other

Enumeration date
04/12/2021
Last updated
07/11/2022
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