Healthcare Provider Details

I. General information

NPI: 1962841510
Provider Name (Legal Business Name): RACHEL A MAHER,DMD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 04/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2036 FOULK RD SUITE 200
WILMINGTON DE
19810-3648
US

IV. Provider business mailing address

2036 FOULK RD SUITE 200
WILMINGTON DE
19810-3648
US

V. Phone/Fax

Practice location:
  • Phone: 302-475-7640
  • Fax: 302-475-1700
Mailing address:
  • Phone: 302-475-7640
  • Fax: 302-475-1700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberG1-0001142
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberG1-0001142
License Number StateDE

VIII. Authorized Official

Name: DR. RACHEL A MAHER
Title or Position: PEDIATRIC DENTIST/OWNER
Credential: DMD
Phone: 302-475-7640