| NPI | 1528307881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER J AYERS Owner 304-594-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WV 3859) |
| Additional Taxonomies | 122300000X Dentist (Licence: WV 3882) |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2013-02-06 |