# CHRISTOPHER J RODEBAUGH, DDS INC

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

## Provider details

- **NPI number:** 1043658503
- **Authorized official:** DR. CHRISTOPHER J RODEBAUGH (DENTIST)
- **Authorized official phone:** (304) 645-3110

## Contact information

- **Practice address:** 120 MAPLEWOOD AVE, RONCEVERTE, WV 24970-9736
- **Practice address phone:** (304) 645-3110
- **Practice address fax:** (304) 645-3209
- **Mailing address:** 120 MAPLEWOOD AVE, RONCEVERTE, WV 24970-9736
- **Mailing address phone:** (304) 645-3110
- **Mailing address fax:** (304) 645-3209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3820 | WV | Yes |

## Other

- **Enumeration date:** 06/06/2013
- **Last updated:** 06/06/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 38100178725 | — | WV |