| NPI | 1215385935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT REO OKUBO Dds/Owner 304-379-8101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WV wv2976) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2016-06-03 |