Individual
CODY REED LOCKHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
26496 MIDLAND TRAIL, HICO, WV 25854
(304) 658-5282
(304) 658-5299
Mailing address
PO BOX 497, HICO, WV 25854
(304) 658-5282
(304) 658-5299
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3823
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810013462
—
WV
Enumeration date
09/17/2008
Last updated
10/11/2012
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