| NPI | 1699588525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DINA VAUGHAN Office Manager 304-645-2333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2025-01-27 |
| Last Update Date | 2025-01-27 |