NPI | 1710067269 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN MATTHEW MATHIAS Vice President Dentist 304-267-8702 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WV WV 1794) |
Enumeration Date | 2006-10-17 |
Last Update Date | 2020-08-22 |