| NPI | 1508264094 |
|---|---|
| Doing Business As | BUCKHANNON FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | JEFFREY D. COFFMAN Dentist 304-472-1122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WV 3582) |
| Additional Taxonomies | 122300000X Dentist (Licence: WV 3825) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2014-12-15 |