| Clyde A. Maxwell Jr., Pa | |
|
303 E Lea Blvd Wilmington DE 19802-2353 | |
| (302) 765-3373 | |
| (302) 765-3379 |
| Full Name | Clyde A. Maxwell Jr., Pa |
|---|---|
| Speciality | Dentist |
| Location | 303 E Lea Blvd, Wilmington, Delaware |
| Authorized Official Name and Position | Clyde A Maxwell (DENTIST) |
| Authorized Official Contact | 3024768896 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clyde A. Maxwell Jr., Pa 303 E Lea Blvd Wilmington DE 19802-2353 Ph: (302) 476-8896 | Clyde A. Maxwell Jr., Pa 303 E Lea Blvd Wilmington DE 19802-2353 Ph: (302) 765-3373 |
| NPI Number | 1053464560 |
|---|---|
| Provider Enumeration Date | 01/19/2007 |
| Last Update Date | 06/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053464560 | NPI | - | NPPES |
| 1000040828 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | G1-0001159 (Delaware) | Primary |
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