Healthcare Provider Details

I. General information

NPI: 1790997195
Provider Name (Legal Business Name): LOIS JAMES D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 ATLANTIC AVE SUITE 4
OCEAN VIEW DE
19970-9115
US

IV. Provider business mailing address

17 ATLANTIC AVE SUITE 4
OCEAN VIEW DE
19970-9115
US

V. Phone/Fax

Practice location:
  • Phone: 302-537-4500
  • Fax: 302-537-0800
Mailing address:
  • Phone: 302-537-4500
  • Fax: 302-537-0800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberG10001083
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: