# MITRI A. GHAREEB, DDS, PC

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

## Provider details

- **NPI number:** 1083853683
- **Authorized official:** DR. MITRI ALBERTO GHAREEB DDS (PRESIDENT)
- **Authorized official phone:** (304) 776-4541

## Contact information

- **Practice address:** 5480 BIG TYLER ROAD, SUITE 1, CROSS LANES, WV 25313
- **Practice address phone:** (304) 776-1212
- **Practice address fax:** (304) 776-4542
- **Mailing address:** 5480 BIG TYLER ROAD, SUITE 1, CROSS LANES, WV 25313
- **Mailing address phone:** (304) 776-1212
- **Mailing address fax:** (304) 776-4542

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3713 | WV | Yes |

## Other

- **Enumeration date:** 02/05/2009
- **Last updated:** 05/26/2016