| NPI | 1124129937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SOKOLOSKY President 304-343-5161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WV 2578-78) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-08-22 |