Organization
WV PEDIATRIC DENTISTRY PLLC
Active
Other names
WV Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IIAYA RAMANAN RAJAGOPAL BDS (OWNER)
(205) 249-6175
Entity
Organization
Contact information
Practice address
1004 SUSHRUTA DR STE D, MARTINSBURG, WV 25401-8801
(205) 249-6175
Mailing address
1004 SUSHRUTA DR STE D, MARTINSBURG, WV 25401-8801
(205) 249-6175
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
01/10/2022
Last updated
01/10/2022
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