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Individual

DR. JAY EDWARD CUNNINGHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
35 E BENJAMIN DR, NEW MARTINSVILLE, WV 26155-2705
(304) 455-5644
(304) 455-5644
Mailing address
35 E BENJAMIN DR, NEW MARTINSVILLE, WV 26155-2705
(304) 455-5644
(304) 455-5644

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2031
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0134966000
WV
Enumeration date
12/20/2006
Last updated
07/09/2007
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