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Organization

WEST VIRGINIA UNIVERSITY

Active
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Organization

WEST VIRGINIA UNIVERSITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ASHLEY NICOLE CLARK DDS (ASSISTANT PROFESSOR)
(304) 293-1127
Entity
Organization

Contact information

Practice address
1 MEDICAL CENTER DRIVE, ORAL SURGERY DEPARTMENT, MORGANTOWN, WV 26506
(304) 293-1127
(304) 293-3674
Mailing address
PO BOX 9475, 1 MEDICAL CENTER DRIVE, MORGANTOWN, WV 26506
(304) 293-1127
(304) 293-3674

Taxonomy

Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
4076
WV

Other

Enumeration date
04/17/2015
Last updated
04/17/2015
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