| NPI | 1538132865 |
|---|---|
| Doing Business As | KINGWOOD FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | CHRISTINE LAVONNE DEARTH Owner President 304-329-3142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WV 3416) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2020-08-22 |