| NPI | 1366870818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY DOLAN Office Manager 304-546-2024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WV 3780) |
| Enumeration Date | 2013-10-21 |
| Last Update Date | 2021-06-17 |