Individual
MR. DAVID A LATTANZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
700 WEST PIKE STREET, SUITE 100, CLARKSBURG, WV 26301
(304) 622-4828
(304) 624-0977
Mailing address
700 WEST PIKE STREET, SUITE 100, CLARKSBURG, WV 26301
(304) 622-4828
(304) 624-0977
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2692
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0138397000
—
WV
Enumeration date
11/03/2006
Last updated
07/08/2007
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