Provider First Line Business Practice Location Address:
DEPARTMENT OF ORAL SURGERY ROOM 1200 HSC NORTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORGANTOWN
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-293-2841
Provider Business Practice Location Address Fax Number:
304-293-3674
Provider Enumeration Date:
03/31/2020