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General NPI Number Information
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NPI Number | 1003605338
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Entity Type | Organization
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Legal Business Name | HOCKESSIN SMILE STUDIO, LLC
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 5341 LIMESTONE RD
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City | WILMINGTON
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State | DE
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Zip | 19808-1222
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Country | US
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Telephone | 443-593-5479
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Fax |
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Provider Business Mailing Address
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Address Line | 1234 MADISON LN
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City | HOCKESSIN
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State | DE
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Zip | 19707-9417
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Country | US
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Telephone | 443-593-5479
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RYAN PATRICK ECKLEY
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Credential | DDS
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Telephone | 443-593-5479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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