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General NPI Number Information
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NPI Number | 1558452177
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Entity Type | Organization
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Legal Business Name | ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.A.
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 2601 ANNAND DR STE 10
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City | WILMINGTON
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State | DE
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Zip | 19808-3719
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Country | US
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Telephone | 302-998-0331
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Fax | 302-998-5410
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Provider Business Mailing Address
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Address Line | 2601 ANNAND DR STE 10
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City | WILMINGTON
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State | DE
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Zip | 19808-3719
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Country | US
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Telephone | 302-998-0331
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Fax | 302-998-5410
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID KING
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Credential | DMD
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Telephone | 302-998-0331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | GI-0001107
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License Number State | DE
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