NPI | 1831123850 |
---|---|
Entity Type | Organization |
Authorized Contact | PAUL A. GILLEY Owner/President 304-425-2978 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 2854) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2013-05-29 |