| NPI | 1275631871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL S. BRANNON Partner 304-927-2775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV WV2812) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-01-04 |