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General NPI Number Information
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NPI Number | 1548085442
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Entity Type | Organization
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Legal Business Name | WILMINGTON-APPALOOSA LLC
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 1 WINSTON AVE
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City | WILMINGTON
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State | DE
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Zip | 19804-1760
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Country | US
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Telephone | 302-656-8266
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Fax |
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Provider Business Mailing Address
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Address Line | 1 WINSTON AVE
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City | WILMINGTON
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State | DE
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Zip | 19804-1760
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | NICHOLAS DEBARI
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Credential |
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Telephone | 929-618-7162
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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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