Provider Demographics
NPI:1679139448
Name:DELAWARE BRACES, LLC
Entity Type:Organization
Organization Name:DELAWARE BRACES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MSD
Authorized Official - Phone:302-838-1400
Mailing Address - Street 1:2444 PULASKI HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-3906
Mailing Address - Country:US
Mailing Address - Phone:302-838-1400
Mailing Address - Fax:302-838-2232
Practice Address - Street 1:2444 PULASKI HWY STE 200
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-3906
Practice Address - Country:US
Practice Address - Phone:302-838-1400
Practice Address - Fax:302-838-2232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty