# VALLEY HEALTH WAYNE DENTAL SERVICES

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

## Provider details

- **NPI number:** 1104278209
- **Authorized official:** MARY-BETH BRUBECK (VICE PRESIDENT OF FINANCE / CFO)
- **Authorized official phone:** (304) 525-3334

## Contact information

- **Practice address:** 42 MCGINNIS DRIVE, WAYNE, WV 25570
- **Practice address phone:** (304) 272-5136
- **Practice address fax:** (304) 272-3807
- **Mailing address:** PO BOX 1680, HUNTINGTON, WV 25717-1680
- **Mailing address phone:** (304) 697-1396
- **Mailing address fax:** (304) 697-2086

## Taxonomy

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

## Other

- **Enumeration date:** 07/13/2016
- **Last updated:** 02/08/2022