| Delaware Center For Oral Surgery And Dental Implants Pa | |
|
131 E Chestnut Hill Rd Newark DE 19713-4043 | |
| (302) 369-1000 | |
| (302) 369-6016 |
| Full Name | Delaware Center For Oral Surgery And Dental Implants Pa |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 131 E Chestnut Hill Rd, Newark, Delaware |
| Authorized Official Name and Position | David B Ettinger (PHYSICIAN ORAL SURGEON) |
| Authorized Official Contact | 3023691000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Delaware Center For Oral Surgery And Dental Implants Pa 113 Interlachen Ct Avondale PA 19311-9747 Ph: () - | Delaware Center For Oral Surgery And Dental Implants Pa 131 E Chestnut Hill Rd Newark DE 19713-4043 Ph: (302) 369-1000 |
| NPI Number | 1265585582 |
|---|---|
| Provider Enumeration Date | 01/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265585582 | NPI | - | NPPES |
| 0000932401 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | C10005329 (Delaware) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | G10001099 (Delaware) | Secondary |
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