| NPI | 1366553695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY GRANT NAYLOR Member 304-329-2682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 1969) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-09-09 |