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General NPI Number Information
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NPI Number | 1013089895
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Entity Type | Organization
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Legal Business Name | STATE OF DELAWARE
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 417 FEDERAL ST
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City | DOVER
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State | DE
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Zip | 19901-3635
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Country | US
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Telephone | 302-744-4849
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Fax | 302-739-1613
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Provider Business Mailing Address
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Address Line | 417 FEDERAL ST
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City | DOVER
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State | DE
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Zip | 19901-3635
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Country | US
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Telephone | 302-744-4861
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Fax | 302-739-1613
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Authorized Official
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Title or Position | DIVISION DIRECTOR
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Name | STEVEN L BLESSING
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Credential |
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Telephone | 302-744-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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