| NPI | 1457415135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS E CONDRON Dentist 304-623-4984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV WV1963) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2017-03-14 |