Provider Demographics
NPI:1932285756
Name:ISAACS AND ISAACS FAMILY DENTISTRY
Entity Type:Organization
Organization Name:ISAACS AND ISAACS FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LYON
Authorized Official - Last Name:ISAACS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:302-654-1328
Mailing Address - Street 1:707 FOULK ROAD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803
Mailing Address - Country:US
Mailing Address - Phone:302-654-1328
Mailing Address - Fax:302-655-0602
Practice Address - Street 1:707 FOULK ROAD
Practice Address - Street 2:103
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803
Practice Address - Country:US
Practice Address - Phone:302-654-1328
Practice Address - Fax:302-655-0602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG10000925122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0001078031Medicaid