| |
1202 Foulk Road Wilmington DE 19803 | |
(302) 273-8300 | |
Not Available |
Full Name | |
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Speciality | Dentist |
Location | 1202 Foulk Road, Wilmington, Delaware |
Authorized Official Name and Position | David Han Dieu (PRESIDENT) |
Authorized Official Contact | 3022738300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1202 Foulk Road Wilmington DE 19803 Ph: (302) 273-8300 | 1202 Foulk Road Wilmington DE 19803 Ph: (302) 273-8300 |
NPI Number | 1659739456 |
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Provider Enumeration Date | 02/08/2016 |
Last Update Date | 03/16/2016 |
Medicare PECOS PAC ID | 9830483395 |
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Medicare Enrollment ID | O20160805000450 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659739456 | NPI | - | NPPES |
102705221000 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
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1223S0112X | Dentist - Oral And Maxillofacial Surgery | G1-0001324 (Delaware) | Primary |
Provider Name | David Dieu |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1801001516 PECOS PAC ID: 1052547320 Enrollment ID: I20160808000186 |
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