Provider Demographics
NPI:1114305976
Name:PRACTICE WITHOUT PRESSURE PIKE CREEK
Entity Type:Organization
Organization Name:PRACTICE WITHOUT PRESSURE PIKE CREEK
Other - Org Name:PRACTICE WITHOUT PRESSURE PIKE CREEK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:THOMAS-GLAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:302-635-7837
Mailing Address - Street 1:3105 LIMESTONE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-2147
Mailing Address - Country:US
Mailing Address - Phone:302-635-7873
Mailing Address - Fax:
Practice Address - Street 1:3105 LIMESTONE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-2147
Practice Address - Country:US
Practice Address - Phone:302-635-7873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2015601326261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service