| NPI | 1982006938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MORROW CROUT Owner 304-562-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WV 3374) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WV 3824) |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2014-09-22 |