Provider Demographics
NPI:1154015444
Name:DAK GROUP, LLC
Entity type:Organization
Organization Name:DAK GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:DELLOSE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:302-998-2244
Mailing Address - Street 1:3105 LIMESTONE RD STE 304
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-2156
Mailing Address - Country:US
Mailing Address - Phone:302-998-2244
Mailing Address - Fax:
Practice Address - Street 1:3105 LIMESTONE RD STE 304
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-2156
Practice Address - Country:US
Practice Address - Phone:302-998-2244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-08
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty