Individual
DR. DOUGLAS WAYNE O'DELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1210 VIRGINIA ST E, CHARLESTON, WV 25301-2928
(303) 345-1210
(304) 345-1211
Mailing address
1210 VIRGINIA ST E, CHARLESTON, WV 25301-2928
(303) 345-1210
(304) 345-1211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2193
WV
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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