| NPI | 1154729994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK D JARRELL President 304-574-2833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 3575) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WV 3932) |
| Enumeration Date | 2014-12-10 |
| Last Update Date | 2014-12-10 |