Individual
BRYAN DENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 388-4155
Mailing address
1400 HOSPITAL DR, HURRICANE, WV 25526-9202
(800) 875-0136
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00627
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001718070
WV BCBS
WV
01
—
1069526
WV DWC
WV
Enumeration date
12/19/2005
Last updated
01/24/2017
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