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Individual

DR. SCOTT REO OKUBO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
147 GREEN & MAIN, BRUCETON MILLS, WV 26519
(304) 379-8101
(304) 379-8102
Mailing address
PO BOX 147, BRUCETON MILLS, WV 26525
(304) 379-8101
(304) 379-8102

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2976
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0134013000
WV
Enumeration date
12/28/2006
Last updated
07/08/2007
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