| NPI | 1619096930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E BRICKER Dentist 304-727-2294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 1443) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-09-20 |