Organization
APPALACHIAN ORAL SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW ELWOOD KOEPKE DDS (MEMBER)
(304) 904-7145
Entity
Organization
Contact information
Practice address
3433 UNIVERSITY AVE, SUITE 1, MORGANTOWN, WV 26505-3052
(304) 322-4532
Mailing address
3433 UNIVERSITY AVE, SUITE 1, MORGANTOWN, WV 26505-3052
(304) 322-4532
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4011
WV
Other
Enumeration date
04/09/2017
Last updated
04/09/2017
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