| NPI | 1992905129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY T LOUGH Pediatric Dentist / Owner 304-722-7221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WV 3415) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WV 3783) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2013-06-13 |