| NPI | 1366865552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA SUSAN LUCIANO PARKER General Dentist 304-579-7508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2014-01-24 |
| Last Update Date | 2014-01-24 |