| NPI | 1710030697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARREN SHANE HOLMES Orthodontist And President 304-343-3672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: WV 3383) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-08-22 |