Organization
ETHAN LAFFERTY, DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ETHAN SHAMUS LAFFERTY DDS (OWNER)
(304) 327-7135
Entity
Organization
Contact information
Practice address
1321 STADIUM DR, BLUEFIELD, WV 24701-3318
(304) 327-7135
(304) 327-0758
Mailing address
1321 STADIUM DR, BLUEFIELD, WV 24701-3318
(304) 327-7135
(304) 327-0758
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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