Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | G1-0000926 | DE |
NPI | 1013125392 |
---|---|
Provider Name | Dr. Debra Joan Pace |
First Address | Wilmington, DE 19810-4445 |
Second Address | Wilmington, DE 19810-4445 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 08/07/2007 |