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General NPI Number Information
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NPI Number | 1689392508
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Entity Type | Organization
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Legal Business Name | DENTISTRY OF HOCKESSIN
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Dates
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Enumeration Date | 08/16/2022
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 1127 VALLEY RD STE 203
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City | HOCKESSIN
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State | DE
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Zip | 19707-8514
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Country | US
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Telephone | 302-235-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 166 JUSTIN DR
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City | WEST CHESTER
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State | PA
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Zip | 19382-3428
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Country | US
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Telephone | 304-319-3251
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GARRETT BRINK
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Credential | DMD
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Telephone | 304-319-3251
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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 |
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License Number State |
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