| NPI | 1316035017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP M MAJESTRO Vice President 304-344-4003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WV 3193) |
| Additional Taxonomies | 122300000X Dentist (Licence: WV 3130) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-08-22 |