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General NPI Number Information
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NPI Number | 1538866108
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Entity Type | Organization
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Legal Business Name | LOUIE PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 02/14/2023
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 250 BEISER BLVD STE 101
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City | DOVER
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State | DE
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Zip | 19904-7795
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Country | US
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Telephone | 302-674-5437
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Fax | 302-672-9091
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Provider Business Mailing Address
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Address Line | 250 BEISER BLVD STE 101
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City | DOVER
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State | DE
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Zip | 19904-7795
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Country | US
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Telephone | 302-674-5437
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Fax | 302-672-9091
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Authorized Official
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Title or Position | OWNER
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Name | DR. PHILLIP JAMES LOUIE
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Credential | DMD
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Telephone | 302-674-5437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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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 | 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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