| NPI | 1790186682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS LESLIE Owner/Dentist 304-258-2291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 2484) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2014-09-10 |