Individual
DR. JASON GREGORY GUMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.,P.L.L.C.
Contact information
Practice address
176 MONROE AVE, RIVESVILLE, WV 26588
(304) 278-5900
(304) 278-5913
Mailing address
PO BOX 100, RIVESVILLE, WV 26588-0100
(304) 278-5900
(304) 278-5913
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3414
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7800065-000
—
WV
Enumeration date
10/31/2006
Last updated
07/08/2007
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