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111 S Grove St Ste 1 Petersburg WV 26847-1770 | |
| (304) 257-2451 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 111 S Grove St Ste 1, Petersburg, West Virginia |
| Authorized Official Name and Position | Melissa Thompson (CEO) |
| Authorized Official Contact | 3048975915 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 97 Baker WV 26801-0097 Ph: (304) 897-5915 | 111 S Grove St Ste 1 Petersburg WV 26847-1770 Ph: (304) 257-2451 |
| NPI Number | 1033347414 |
|---|---|
| Provider Enumeration Date | 06/24/2009 |
| Last Update Date | 01/16/2024 |
| Medicare PECOS PAC ID | 6204728041 |
|---|---|
| Medicare Enrollment ID | O20090623000048 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033347414 | NPI | - | NPPES |
David E. Harman M.a. , D.d.s. , Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 14 S Main St, Petersburg, WV 26847 Phone: 304-257-4770 Fax: 304-257-5475 | |
Jeffrey G. Kimble Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 Virginia Ave, Petersburg, WV 26847 Phone: 304-257-1759 |