| NPI | 1407974264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM DOUGLAS ROBERTSON Member 304-233-4851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: WV 2598) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |