# WEST VIRGINIA UNIVERSTIY DENTAL CORPORATION

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

## Provider details

- **NPI number:** 1114367695
- **Authorized official:** DIANE HESS (MANAGER, DENTAL BILLING)
- **Authorized official phone:** (304) 293-2240

## Contact information

- **Practice address:** 451/453 SUNCREST TOWN CENTRE DRIVE, MORGANTOWN, WV 26505
- **Practice address phone:** (304) 293-2240
- **Practice address fax:** (304) 293-7646
- **Mailing address:** PO BOX 1587, MORGANTOWN, WV 26507-1587
- **Mailing address phone:** (304) 293-6129
- **Mailing address fax:** (304) 293-7646

## Taxonomy

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

## Other

- **Enumeration date:** 06/28/2013
- **Last updated:** 06/28/2013