| NPI | 1508039017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN A DAVIS Dentist Owner 304-375-7742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 2096) |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2008-04-04 |