| NPI | 1578998381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILL J. GIBSON Managing Member 304-965-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 2220) |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2018-02-28 |