| Clay Dental Clinic | |
|
63 Carr St Clay WV 25043-0000 | |
| (304) 587-4232 | |
| (304) 587-2092 |
| Full Name | Clay Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 63 Carr St, Clay, West Virginia |
| Authorized Official Name and Position | Russell Brooks Legg (OWNER) |
| Authorized Official Contact | 3045874232 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clay Dental Clinic 63 Carr St P.o Box 568 Clay WV 25043-9402 Ph: (304) 587-4232 | Clay Dental Clinic 63 Carr St Clay WV 25043-0000 Ph: (304) 587-4232 |
| NPI Number | 1912088410 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 06/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912088410 | NPI | - | NPPES |
| 3810005754 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | WV2123 (West Virginia) | Primary |
John G. Hubbard, Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 63 Carr St, Clay, WV 25043 Phone: 304-587-4232 Fax: 304-587-2092 | |
Bowen Dental Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 319 Main St, Clay, WV 25043 Phone: 304-587-7495 Fax: 304-587-7425 |