Organization
PAYTON SOUTHALL, DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAYTON SOUTHALL DDS (PEDIATRIC DENTIST)
(304) 252-0472
Entity
Organization
Contact information
Practice address
220 RAGLAND RD, BECKLEY, WV 25801-9721
(304) 252-0472
Mailing address
323 SHAWNEE CIR, MOUNT HOPE, WV 25880-8988
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/15/2024
Last updated
05/05/2024
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