NPI 1265585046

Delaware Modern Dental

Organisation General Practice Dentistry Newark, DE

Practice location

Address: 850 Library Ave Suite 102, Newark, DE 19711-7170
Phone: (302) 366-8668
Fax: (302) 366-8081

Authorised official

Name: Lisa Fagioletti
Title: Dentist
Phone: (302) 366-8668

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 2005207645 (DE)

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Registry record

NPI: 1265585046
Entity type: Organization
NPI issued: 18 Jan 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.