Provider Demographics
NPI:1184855520
Name:DOVER FAMILY AND COSMETIC DENTISTRY
Entity type:Organization
Organization Name:DOVER FAMILY AND COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUNIOR
Authorized Official - Middle Name:ANDERSON
Authorized Official - Last Name:DOVER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:302-672-7766
Mailing Address - Street 1:1084 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-6925
Mailing Address - Country:US
Mailing Address - Phone:302-672-7766
Mailing Address - Fax:302-672-7769
Practice Address - Street 1:1084 S STATE ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-6925
Practice Address - Country:US
Practice Address - Phone:302-672-7766
Practice Address - Fax:302-672-7769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-03
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-0001245261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental