# CRUIKSHANK & MATHIAS DENTISTS INC

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

## Provider details

- **NPI number:** 1710067269
- **Authorized official:** DR. JOHN MATTHEW MATHIAS DDS (VICE PRESIDENT DENTIST)
- **Authorized official phone:** (304) 267-8702

## Contact information

- **Practice address:** 215 S LOUISIANA AVENUE, MARTINSBURG, WV 25401-2037
- **Practice address phone:** (304) 267-8702
- **Practice address fax:** (304) 263-2787
- **Mailing address:** 215 S LOUISIANA AVENUE, MARTINSBURG, WV 25401-2037
- **Mailing address phone:** (304) 267-8702
- **Mailing address fax:** (304) 263-2787

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | WV 1794 | WV | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 08/22/2020