Provider First Line Business Practice Location Address:
599 MEDICAL CENTER DR.
Provider Second Line Business Practice Location Address:
WVU SCHOOL OF DENTISTRY, HEALTH SCIENCES NORTH
Provider Business Practice Location Address City Name:
MORGANTOWN
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26506-9407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-293-1980
Provider Business Practice Location Address Fax Number:
304-293-8561
Provider Enumeration Date:
09/28/2012