| NPI | 1013859909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEY COYNER Accts Receivable Director 304-552-7688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2026-04-08 |
| Last Update Date | 2026-06-29 |