Individual
DR. JOHN BYRON WILFONG II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
19 E MAIN ST, BUCKHANNON, WV 26201-2715
(304) 472-4954
(304) 472-8898
Mailing address
516 COST AVE, STONEWOOD, WV 26301-4811
(304) 624-5250
(304) 624-5251
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3375
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4004052000
DENTAL WV MEDICAL CARD
WV
Enumeration date
09/20/2006
Last updated
07/08/2007
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