DOVER ORAL AND MAXILLOFACIAL SURGERY NPI 1619102811

NPI Information

  • NPI: 1619102811
  • Provider Name: DOVER ORAL AND MAXILLOFACIAL SURGERY
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 712 S GOVERNORS AVE
    DOVER, DE
    ZIP 19904
  • Phone: (302) 674-1140

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NPI Details

DOVER ORAL AND MAXILLOFACIAL SURGERY is an oral and maxillofacial surgery dentist in Dover, DE. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DOVER ORAL AND MAXILLOFACIAL SURGERY NPI is 1619102811. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

712 S GOVERNORS AVE
DOVER, DE
ZIP 19904-106
Phone: (302) 674-1140

The provider's authorized official is Franklin Xavier Pancko .
The authorized official title is Oral And Maxillofacial Surgeon and has the following contact phone number (443) 939-0942.

The enumeration date for this NPI number is 5/18/2009 and was last updated on 5/18/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryG1-0001269DELAWAREYes

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This page was last updated on: 11/21/2025

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