| NPI | 1194142984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHFAQ AHMAD Dentist 304-216-6234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 10476) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 10476) |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2014-03-18 |