Individual
ETHAN SHAMUS LAFFERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
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
122300000X
Dentist
Primary
4224
WV
Other
Enumeration date
07/22/2016
Last updated
09/21/2023
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