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General NPI Number Information
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NPI Number | 1699861963
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Entity Type | Organization
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Legal Business Name | FAMILY DENTISTRY OF MILFORD PA
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 100 SUSSEX AVE
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City | MILFORD
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State | DE
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Zip | 19963-1823
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Country | US
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Telephone | 302-422-6924
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Fax | 302-422-6768
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Provider Business Mailing Address
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Address Line | 100 SUSSEX AVE
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City | MILFORD
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State | DE
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Zip | 19963-1823
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Country | US
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Telephone | 302-422-6924
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Fax | 302-422-6768
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. JOHN WILLIAM BAUSCH JR.
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Credential | DDS
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Telephone | 302-422-6924
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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 | 1991836116
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License Number State | DE
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