Organization
CHARLES E. SAMMONS, DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES E SAMMONS DDS (OWNER)
(304) 393-1030
Entity
Organization
Contact information
Practice address
180 MINGO AVENUE, KERMIT, WV 25674-0248
(304) 393-1030
(304) 393-1026
Mailing address
180 MINGO AVENUE, P.O. BOX 248, KERMIT, WV 25674-0248
(304) 393-1030
(304) 393-1026
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2668
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136867000
—
WV
Enumeration date
09/23/2008
Last updated
09/23/2008
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