Individual
DR. LEAH RAE HAIRSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
112 LEE ST W, CHARLESTON, WV 25302-2342
(304) 342-0146
Mailing address
112 LEE ST W, CHARLESTON, WV 25302-2342
(304) 342-0146
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4152
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810005399
—
WV
Enumeration date
06/03/2015
Last updated
06/03/2015
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