| NPI | 1346333168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAT SHUMATE Office Manager 304-252-8609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2010-01-19 |