# CHEAT LAKE FAMILY DENTISTRY

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

## Provider details

- **NPI number:** 1467800417
- **Authorized official:** DR. ALLISON WILSON (OWNER)
- **Authorized official phone:** (304) 594-9005

## Contact information

- **Practice address:** 230 LAKEWOOD CTR, MORGANTOWN, WV 26508-4457
- **Practice address phone:** (304) 594-9005
- **Mailing address:** 230 LAKEWOOD CTR, MORGANTOWN, WV 26508-4457

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3565 | WV | Yes |
| 1223G0001X | General Practice Dentistry | 3574 | WV | — |

## Other

- **Enumeration date:** 06/01/2016
- **Last updated:** 06/01/2016