| Jrl Dental Dba Grace Dental Care | |
|
15081 Maccorkle Ave Chelyan WV 25035 | |
| (304) 595-3551 | |
| (304) 595-6822 |
| Full Name | Jrl Dental Dba Grace Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 15081 Maccorkle Ave, Chelyan, West Virginia |
| Authorized Official Name and Position | Jason R Long (OWNER) |
| Authorized Official Contact | 3047846665 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jrl Dental Dba Grace Dental Care 1628 W 3rd Ave Williamson WV 25661-3007 Ph: () - | Jrl Dental Dba Grace Dental Care 15081 Maccorkle Ave Chelyan WV 25035 Ph: (304) 595-3551 |
| NPI Number | 1043866338 |
|---|---|
| Provider Enumeration Date | 08/13/2019 |
| Last Update Date | 08/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043866338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Grace Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15081 Maccorkle Ave, Chelyan, WV 25035 Phone: 304-595-3551 Fax: 304-595-6822 |