| NPI | 1902160096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK HENRY SAMMONS Orthdoontist 304-522-3512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2015-08-25 |