Healthcare Provider Details

I. General information

NPI: 1932706108
Provider Name (Legal Business Name): DENTAL MANAGEMENT STRATEGIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2020
Last Update Date: 10/01/2020
Certification Date: 10/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LANTANA DR
HOCKESSIN DE
19707-8813
US

IV. Provider business mailing address

1415 FOULK RD STE 201
WILMINGTON DE
19803-2748
US

V. Phone/Fax

Practice location:
  • Phone: 302-239-5917
  • Fax: 302-239-3657
Mailing address:
  • Phone: 302-230-3090
  • Fax: 302-230-3082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: ERIK BRADLEY
Title or Position: DENTIST
Credential: DDS
Phone: 302-239-5917