| NPI | 1548311921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY LOUIS CAMELE President 304-986-2610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 2351) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WV 2766) |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2020-08-22 |