Individual
CHARLES EDWARD SAMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
180 MINGO AVE, KERMIT, WV 25674
(304) 393-1030
Mailing address
180 MINGO AVE, KERMIT, WV 25674
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2668
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136867000
—
WV
Enumeration date
08/05/2007
Last updated
08/05/2007
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