Individual
DR. L. EDWARD ECKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.,M.S.
Contact information
Practice address
1804 HARPER RD, BECKLEY, WV 25801-3331
(304) 252-0771
Mailing address
1804 HARPER RD, BECKLEY, WV 25801-3331
(304) 252-0771
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2040
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0137774000
—
WV
01
—
0550596553
FEDERAL ID NUMBER
WV
Enumeration date
11/06/2006
Last updated
07/08/2007
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