Provider Demographics
NPI:1013125392
Name:PACE, DEBRA JOAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:JOAN
Last Name:PACE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 SILVERSIDE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4445
Mailing Address - Country:US
Mailing Address - Phone:302-529-2500
Mailing Address - Fax:302-529-2503
Practice Address - Street 1:1405 SILVERSIDE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4445
Practice Address - Country:US
Practice Address - Phone:302-529-2500
Practice Address - Fax:302-529-2503
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00009261223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics