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100a Prestige Park Dr Hurricane WV 25526 | |
| (304) 757-0272 | |
| (304) 757-0273 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 100a Prestige Park Dr, Hurricane, 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 |
|---|---|
103 Station Place Way Hurricane WV 25526-8747 Ph: (304) 345-1092 | 100a Prestige Park Dr Hurricane WV 25526 Ph: (304) 757-0272 |
| NPI Number | 1992766737 |
|---|---|
| Provider Enumeration Date | 03/31/2006 |
| Last Update Date | 12/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992766737 | NPI | - | NPPES |
| 000817140 | Other | WV | MT. STATE BCBS |
| 4500012000 | Medicaid | WA | |
| 9305402 | Other | WV | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
Kerry Kendrick, Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 Chase Dr, Hurricane, WV 25526 Phone: 304-757-7792 Fax: 304-757-7808 | |
Dr Michael A Joseph Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3 Davis Court, Hurricane, WV 25526 Phone: 304-562-7117 Fax: 304-562-7118 | |
Samuel D O'dell, Dds, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3712 Teays Valley Rd, Hurricane, WV 25526 Phone: 304-757-9389 Fax: 304-757-3296 | |
Matthew C O'dell, Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3518 Teays Valley Rd, Hurricane, WV 25526 Phone: 304-562-1000 |