# PATRICK JARRELL

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

## Provider details

- **NPI number:** 1154729994
- **Authorized official:** DR. PATRICK D JARRELL DDS (PRESIDENT)
- **Authorized official phone:** (304) 574-2833

## Contact information

- **Practice address:** 213 W MAPLE AVE, FAYETTEVILLE, WV 25840-1413
- **Practice address phone:** (304) 574-2833
- **Practice address fax:** (304) 574-2489
- **Mailing address:** 213 W MAPLE AVE, FAYETTEVILLE, WV 25840-1413
- **Mailing address phone:** (304) 574-2833
- **Mailing address fax:** (304) 574-2489

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3575 | WV | Yes |
| 1223G0001X | General Practice Dentistry | 3932 | WV | — |

## Other

- **Enumeration date:** 12/10/2014
- **Last updated:** 12/10/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 233275554 | — | WV |