Bruceton Dental Pllc | |
128 Green Street Bruceton Mills WV 26525 | |
(304) 379-8101 | |
(304) 379-8102 |
Full Name | Bruceton Dental Pllc |
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Speciality | Clinic/center - Dental |
Location | 128 Green Street, Bruceton Mills, West Virginia |
Authorized Official Name and Position | Scott Reo Okubo (DDS/OWNER) |
Authorized Official Contact | 3043798101 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Bruceton Dental Pllc Po Box 147 Bruceton Mills WV 26525-0147 Ph: (304) 379-8101 | Bruceton Dental Pllc 128 Green Street Bruceton Mills WV 26525 Ph: (304) 379-8101 |
NPI Number | 1215385935 |
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Provider Enumeration Date | 06/03/2016 |
Last Update Date | 06/03/2016 |
Identifier | Type | State | Issuer |
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1215385935 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | WV2976 (West Virginia) | Primary |