| NPI | 1790839918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD H. LOUGH President 304-243-9010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WV 103) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |