| NPI | 1982765517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL JEFFREY CLAY President 304-763-4665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WV 2683) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2009-01-26 |