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General NPI Number Information
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NPI Number | 1245384460
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Entity Type | Organization
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Legal Business Name | DENTAL HEALTH ASSOCIATES OF PIKE CREEK VALLEY, P.A.
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4901 LIMESTONE RD
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City | WILMINGTON
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State | DE
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Zip | 19808-1271
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Country | US
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Telephone | 302-239-0303
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Fax | 302-239-6755
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Provider Business Mailing Address
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Address Line | 4901 LIMESTONE RD
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City | WILMINGTON
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State | DE
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Zip | 19808-1271
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Country | US
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Telephone | 302-239-0303
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Fax | 302-239-6755
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Authorized Official
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Title or Position | TREASURER
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Name | GINA C PIKE
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Credential |
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Telephone | 302-239-0303
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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 | 1989020002
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License Number State | DE
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