| NPI | 1972933570 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | WILLIAM CRAIG BOWEN Owner 304-453-3329 | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 3636) | 
| Enumeration Date | 2013-11-18 | 
| Last Update Date | 2013-11-18 |