| NPI | 1508953159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY E COLE President Of Corporation Dentist 304-664-8163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WV 2991) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-08-22 |