| Mt State Oral & Maxillofacial Surgeons | |
|
3135 16th Street Rd Suite 20 Huntington WV 25701 | |
| (304) 399-1092 | |
| Not Available |
| Full Name | Mt State Oral & Maxillofacial Surgeons |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 3135 16th Street Rd, Huntington, West Virginia |
| Authorized Official Name and Position | Lesley Marie Coyner (CREDENTIALING) |
| Authorized Official Contact | 3047207819 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mt State Oral & Maxillofacial Surgeons 103 Station Place Way Hurricane WV 25526-8747 Ph: (304) 345-1092 | Mt State Oral & Maxillofacial Surgeons 3135 16th Street Rd Suite 20 Huntington WV 25701 Ph: (304) 399-1092 |
| NPI Number | 1053561779 |
|---|---|
| Provider Enumeration Date | 09/30/2008 |
| Last Update Date | 12/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053561779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (West Virginia) | Primary |
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