Provider Demographics
NPI:1851510044
Name:PIKE CREEK DENTAL
Entity Type:Organization
Organization Name:PIKE CREEK DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:M
Authorized Official - Last Name:GIOFFNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-239-0410
Mailing Address - Street 1:4901 LIMESTONE ROAD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808
Mailing Address - Country:US
Mailing Address - Phone:302-239-0410
Mailing Address - Fax:302-239-0367
Practice Address - Street 1:4901 LIMESTONE ROAD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808
Practice Address - Country:US
Practice Address - Phone:302-239-0410
Practice Address - Fax:302-239-0367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE903831122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1427004431OtherNPI INDIVID D GIOFFNE
1114941986OtherNPI INDIVID K WALKER
1427004431OtherNPI INDIVID D GIOFFNE