| NPI | 1881949840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIDGET BOGGS STEVENS Dentist/Owner 304-768-5616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 2883) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2020-06-25 |