| NPI | 1467575290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES KEVIN MARTIN Owner 304-425-4964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 2918) |
| Enumeration Date | 2007-04-08 |
| Last Update Date | 2020-08-22 |