| NPI | 1619053196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA O FRUM Dentist Pres 304-296-3786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 2675) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-08-22 |