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Organization
BRUCETON DENTAL PLLC
Active
Organization
BRUCETON DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT REO OKUBO DDS (DDS/OWNER)
(304) 379-8101
Entity
Organization
Contact information
Practice address
128 GREEN STREET, BRUCETON MILLS, WV 26525
(304) 379-8101
(304) 379-8102
Mailing address
PO BOX 147, BRUCETON MILLS, WV 26525-0147
(304) 379-8101
(304) 379-8102
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
WV2976
WV
Other
Enumeration date
06/03/2016
Last updated
06/03/2016
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