| NPI | 1801200225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | L. DIANE HESS Manager Of Dental Billing 304-293-2240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2014-06-13 |