| NPI | 1346793668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA LYNN PANUCCI President 304-744-6311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2016-08-03 |