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Organization

DR L E SYNER AND DR W M WINE ASSOC IN ORAL & MAXILLOFACIAL SURG INC,

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. PAT SHUMATE (OFFICE MANAGER)
(304) 252-8609
Entity
Organization

Contact information

Practice address
750 STANAFORD RD, BECKLEY, WV 25801-8737
(304) 252-8609
(304) 253-8870
Mailing address
750 STANAFORD RD, BECKLEY, WV 25801-8737
(304) 252-8609
(304) 253-8870

Taxonomy

Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0138270000
WV
05
0138303000
WV
Enumeration date
10/02/2006
Last updated
01/19/2010
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