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Organization
PHILIP A. VICINI DDS.
Active
Organization
PHILIP A. VICINI DDS.
Active
Other names
Sissonville Dental Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP A. VICINI DDS (OWNER/DENTIST)
(304) 984-0052
Entity
Organization
Contact information
Practice address
1086 MARTINS BRANCH ROAD, CHARLESTON, WV 25312
(304) 984-0052
(304) 984-3140
Mailing address
P.O. BOX 13485, CHARLESTON, WV 25360-0485
(304) 984-0052
(304) 984-3140
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2207
WV
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/27/2006
Last updated
03/14/2022
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