Organization
CHEAT LAKE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLISON WILSON (OWNER)
(304) 594-9005
Entity
Organization
Contact information
Practice address
230 LAKEWOOD CTR, MORGANTOWN, WV 26508-4457
(304) 594-9005
Mailing address
230 LAKEWOOD CTR, MORGANTOWN, WV 26508-4457
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3565
WV
1223G0001X
General Practice Dentistry
3574
WV
Other
Enumeration date
06/01/2016
Last updated
06/01/2016
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