Organization
G. BRIAN EVES, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY BRIAN EVES D.D.S. (DENTIST)
(304) 523-2332
Entity
Organization
Contact information
Practice address
4602 ROUTE 152, LAVALETTE, WV 25535-9702
(304) 523-2332
(304) 523-0681
Mailing address
PO BOX 599, LAVALETTE, WV 25535-0599
(304) 523-2332
(304) 523-0681
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3218
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013024000
—
WV
Enumeration date
11/15/2011
Last updated
11/15/2011
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