| Capitol Endodontics, Pllc | |
|
405 Capitol St Suite 914 Charleston WV 25301-1749 | |
| (304) 345-1248 | |
| Not Available |
| Full Name | Capitol Endodontics, Pllc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 405 Capitol St, Charleston, West Virginia |
| Authorized Official Name and Position | Amanda Boustany (OWNER) |
| Authorized Official Contact | 3043451248 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Capitol Endodontics, Pllc 405 Capitol St Suite 914 Charleston WV 25301-1749 Ph: (304) 345-1248 | Capitol Endodontics, Pllc 405 Capitol St Suite 914 Charleston WV 25301-1749 Ph: (304) 345-1248 |
| NPI Number | 1518330463 |
|---|---|
| Provider Enumeration Date | 11/01/2015 |
| Last Update Date | 11/01/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518330463 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 4180 (West Virginia) | Primary |
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