| NPI | 1093023798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ANDREW FLORENCE Owner 304-422-4455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 3450) |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2014-06-05 |