Organization
PETER F. SUBACH DMD,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER F. SUBACH DMD (PRESIDENT)
(302) 995-1870
Entity
Organization
Contact information
Practice address
1601 MILLTOWN RD, SUITE#17, WILMINGTON, DE 19808-4027
(302) 995-1870
(302) 995-9568
Mailing address
1601 MILLTOWN RD, SUITE#17, WILMINGTON, DE 19808-4027
(302) 995-1870
(302) 995-9568
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
G10001087
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OOA187L88
PTAN
—
Enumeration date
05/24/2012
Last updated
05/24/2012
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