Organization
CHRISTIANA CENTER FOR ORAL & MAXILLOFACIAL SURGERY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE MICHAEL DAMICO III D.D.S. (PRESIDENT)
(302) 292-1600
Entity
Organization
Contact information
Practice address
4133 OGLETOWN STANTON RD STE 200, NEWARK, DE 19713-4187
(130) 232-8677
(023) 195-9543
Mailing address
4133 STANTON OGLETWN RD STE 200, NEWARK, DE 19713-4187
(302) 292-1600
(302) 319-5954
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
G1-0000952
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000189002
—
DE
01
—
000540991
HIGHMARK BLUE SHIELD
—
01
—
0116093000
AMERIHEALTH
—
01
—
199367325
CAREFIRST BLUE CROSS BLUE SHIELD OF DELAWARE
DE
01
—
4300241
AETNA
—
Enumeration date
05/23/2006
Last updated
02/09/2023
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