| Premier Oral And Facial Surgery | |
|
1202 Foulk Road Wilmington DE 19803 | |
| (302) 273-8300 | |
| Not Available |
| Full Name | Premier Oral And Facial Surgery |
|---|---|
| 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 |
|---|---|
| Premier Oral And Facial Surgery 1202 Foulk Road Wilmington DE 19803 Ph: (302) 273-8300 | Premier Oral And Facial Surgery 1202 Foulk Road Wilmington DE 19803 Ph: (302) 273-8300 |
| NPI Number | 1659739456 |
|---|---|
| Provider Enumeration Date | 02/08/2016 |
| Last Update Date | 03/16/2016 |
| Medicare PECOS PAC ID | 9830483395 |
|---|---|
| Medicare Enrollment ID | O20160805000450 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659739456 | NPI | - | NPPES |
| 102705221000 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | G1-0001324 (Delaware) | Primary |
| Provider Name | David Dieu |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1801001516 PECOS PAC ID: 1052547320 Enrollment ID: I20160808000186 |
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