| NPI | 1881730844 |
|---|---|
| Doing Business As | TEAYS VALLEY PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JOHN PATRICK MARTIN Pediatric Dentist 304-201-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: WV WV3264) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: WV WV3568) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |