| NPI | 1316330210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN ROBERT ABRAHAM Owner Dentist 304-925-0322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 3622) |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2015-03-17 |