Organization
AVALON DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PARHAM FARHI DDS (OWNER)
(302) 998-9244
Entity
Organization
Contact information
Practice address
301 S OLD DUPONT RD, STE A, WILMINGTON, DE 19804-0000
(302) 998-9244
Mailing address
301 S OLD DUPONT RD, STE A, WILMINGTON, DE 19804-0000
(302) 998-9244
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
G1-10001200
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000038597
—
DE
05
—
1000040450
—
DE
05
—
1000040646
—
DE
Enumeration date
02/09/2007
Last updated
07/02/2008
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