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General NPI Number Information
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NPI Number | 1154015444
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Entity Type | Organization
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Legal Business Name | DAK GROUP, LLC
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Dates
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Enumeration Date | 06/08/2023
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 3105 LIMESTONE RD STE 304
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City | WILMINGTON
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State | DE
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Zip | 19808-2156
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Country | US
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Telephone | 302-998-2244
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Fax |
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Provider Business Mailing Address
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Address Line | 3105 LIMESTONE RD STE 304
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City | WILMINGTON
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State | DE
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Zip | 19808-2156
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Country | US
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Telephone | 302-998-2244
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | MARK DELLOSE
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Credential | DMD
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Telephone | 302-998-2244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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