# DALE E BRUM, D.D.S. INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043329402
- **Authorized official:** DR. DALE ERIC BRUM D.D.S. (PRESIDENT)
- **Authorized official phone:** (304) 428-1151

## Contact information

- **Practice address:** 930 AVERY ST, PARKERSBURG, WV 26101-4725
- **Practice address phone:** (304) 428-1151
- **Practice address fax:** (304) 428-0082
- **Mailing address:** 930 AVERY ST, PARKERSBURG, WV 26101-4725
- **Mailing address phone:** (304) 428-1151
- **Mailing address fax:** (304) 428-0082

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2616 | WV | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 04/27/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000142132 | PROVIDER ID \# | WV |