Individual
DR. KRYSTIN BOURDUA AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3997 BECKLEY RD, PRINCETON, WV 24740-7660
(304) 425-4585
(304) 431-3400
Mailing address
3997 BECKLEY RD, PRINCETON, WV 24740-7660
(304) 431-5499
(304) 431-2661
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4265
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407385735
—
WV
Enumeration date
06/09/2017
Last updated
01/25/2019
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