| NPI | 1093004590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY L KENDRICK Owner/Dentist 304-757-7792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WV 3175) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2011-04-05 |