| NPI | 1568682870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A HAZEY Owner 304-598-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2025-04-08 |