| NPI | 1487863718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIEA EVICK Co Owner And Dentist 304-636-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 3598) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |